Home Health Billing and Accounts Receivable Specialist

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

📋 Description

• Verify Medicaid eligibility, payer assignments, authorizations, service codes, and approved units.

• Submit accurate claims to Medicaid managed care plans and commercial payers.

• Address claim rejections and resubmit corrected claims as necessary.

• Utilize Availity on a daily basis for checking eligibility, claim statuses, remittances, denials, and payer inquiries.

• Investigate and resolve issues related to denials and underpayments, including managing appeals and payment disputes.

• Follow up on unpaid and aged accounts receivable via payer portals and phone communications.

• Monitor timely filing deadlines to ensure compliance.

• Post and reconcile Electronic Remittance Advices (ERAs) and Explanation of Benefits (EOBs) against expected reimbursement amounts.

• Reconcile visits, authorized units, and billed units to identify any unbilled or incorrectly billed services.

• Prepare accounts receivable aging, denial, and collections reports using Excel or Google Sheets.

• Document account activities and escalate payer issues to the team lead as needed.

• Safeguard patient information and adhere to HIPAA regulations.

• Manage multiple agency accounts for home care clients.

⛳️ Requirements

• Minimum of 2 years of experience in U.S. home health billing.

• Extensive hands-on experience with Availity, including aspects such as claim status, remittances, and denials.

• Familiarity with billing procedures for Medicaid managed care plans (MCOs).

• Proven track record in denial management and accounts receivable follow-up.

• Knowledge of commercial insurance and government health plans.

• Proficient in using Excel or Google Sheets.

• Strong command of written and spoken English for effective communication during payer calls and in written disputes.

• Exceptional attention to detail and follow-up abilities.

• Capability to work independently while managing multiple agency accounts.

• Reliable internet access and a conducive remote working environment.

• Availability during Central Time business hours is essential.

• Preferred: Experience in billing for nonmedical home care, personal care, or Home and Community-Based Services (HCBS) waiver programs.

• Preferred: Knowledge of Illinois Medicaid and Illinois Medicaid MCOs such as Aetna Better Health, Blue Cross Community Health Plans, Molina, Meridian, or CountyCare.

• Preferred: Experience with software such as HHAeXchange, AxisCare, CareSmartz360, CareTime, or Axxess.

• Preferred: Experience with Electronic Visit Verification (EVV) visit reconciliation and tracking of authorizations.

🏝️ Benefits

• Remote work arrangement available.

• Full-time employment opportunity.

• Chance to support a revenue cycle company that serves home care agencies.

• Preference given to applicants based in the Philippines.