Billing Specialist

This is a fully remote position, open to applicants in New York.

📋 Description

• Prepare and accurately submit claims or invoices to the relevant payers.

• Assess unpaid, delayed, rejected, or denied claims, and prepare corrected, adjusted, or resubmitted claims.

• Monitor EVV reports, dashboards, and compliance outcomes for missing visits, mismatches, validation errors, failed transmissions, and other anomalies.

• Investigate and rectify routine EVV visit exceptions while verifying visit data processing.

• Reconcile EVV visit information with billing and claim data, addressing discrepancies as needed.

• Collaborate with payers, state agencies, EVV aggregators, HHAeXchange, Medflyt, Sandata, internal operational teams, and vendors to troubleshoot and resolve issues.

• Maintain precise, accurate, and audit-ready records for claims and EVV.

• Generate and review billing, eligibility, claims, and EVV reports.

• Identify recurring billing or EVV challenges, ascertain root causes, and communicate trends along with process enhancements.

• Manage routine billing and EVV issues through to resolution, escalating complex, high-risk, policy, access, contractual, or technical concerns as necessary.

• Ensure accurate and timely submissions, resolve exceptions, manage work queues, and support reimbursement and compliance efforts.

⛳️ Requirements

• High school diploma or equivalent is required.

• An associate or bachelor's degree in business, finance, healthcare administration, or a related field is preferred.

• A minimum of two years of experience in healthcare billing, home care billing, Medicaid, managed care, revenue cycle, or payer operations is preferred.

• Familiarity with CDPAP, LHCSA, SFC, or multi-state home care billing environments is advantageous.

• Experience with EVV workflows, compliance monitoring, visit exception resolution, or EVV aggregators is preferred but not mandatory.

• Proficiency in utilizing HHAeXchange, Medflyt, Sandata, state EVV aggregators, or similar healthcare billing and operations systems is preferred.

• Basic knowledge of Excel is required; intermediate Excel skills are preferred.

• Understanding of billing workflows, claim submission, payer follow-up, denial and rejection analysis, and data accuracy standards.

• Strong attention to detail with the ability to identify discrepancies across claims, authorizations, billing records, and EVV visit data.

• Capability to research errors, identify root causes, follow established procedures, and independently resolve routine to moderately complex payer, system, or data issues.

• Ability to manage a high-volume workload, meet deadlines, and adjust priorities as necessary.

• Excellent and professional communication skills.

• Sound judgment regarding issue resolution and escalation processes.

• A professional, patient, organized, and solutions-oriented mindset.

🏝️ Benefits

• Competitive base pay range of $22.00–$25.00 per hour.

• Occasional travel may be required.