Medical Biller – Accounts Receivable Specialist

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

📋 Description

• Prepare, review, and submit claims for home care services accurately and promptly.

• Assess authorizations, plans of care/service details, schedules, timesheets, EVV records, and supporting documentation prior to billing.

• Confirm billed units, service dates, service codes, rates, authorizations, and caregiver/service documentation.

• Track submitted claims throughout the adjudication and payment processes.

• Post and reconcile payments, remittance details, adjustments, denials, and other account activities.

• Maintain and reconcile accounts receivable, addressing outstanding, unpaid, underpaid, denied, and rejected claims.

• Identify billing inconsistencies and collaborate with internal departments to rectify errors or obtain missing documentation.

• Investigate and resolve claim denials, rejections, underpayments, authorization discrepancies, and reimbursement challenges.

• Amend and resubmit claims as needed, following up until resolution is achieved.

• Communicate effectively with Medicaid Managed Care Plans, insurance providers, payer representatives, and other funding sources.

• Analyze payer remittance information to detect discrepancies between anticipated and actual reimbursements.

• Assist in collections and follow up on overdue balances and aged accounts receivable.

• Keep precise billing records and supporting documentation in line with agency policies and payer guidelines.

• Ensure that billing practices adhere to Medicaid, managed care, EVV, payer, HIPAA, and agency standards.

• Maintain confidentiality regarding patient, employee, payer, and agency information.

• Stay updated on payer changes, billing requirements, reimbursement modifications, and procedural adjustments.

• Collaborate with scheduling, intake, payroll, clinical, compliance, and administrative personnel.

• Support the preparation of billing reports, account reconciliations, audits, and other billing or accounts receivable tasks.

⛳️ Requirements

• Previous experience in medical billing, healthcare billing, home care billing, accounts receivable, or claims processing.

• Experience handling insurance claims, payer reimbursements, denials, collections, and accounts receivable.

• Strong grasp of the billing cycle, including service documentation, claim submission, payment processing, denial resolution, and reconciliation.

• Excellent analytical and problem-solving abilities with a keen attention to detail.

• Capability to identify discrepancies in documentation, schedules, authorizations, units, rates, payments, and claims.

• Ability to independently investigate billing issues and track claims to resolution.

• Strong written and verbal communication skills.

• Competence in managing multiple priorities, adhering to billing deadlines, and keeping organized and accurate records.

• Proficiency in Microsoft Office, especially Excel and Outlook.

• High school diploma or equivalent is required.

• Over 2 years of experience in medical billing, healthcare billing, or accounts receivable is preferred.

• Previous experience in home care or LHCSA billing is highly preferred.

• Familiarity with billing for New York Medicaid Managed Care Plans is strongly preferred.

• Knowledge of Medicaid, managed care authorizations, EVV, claim submission, remittance, denial management, and reimbursement processes.

• Experience with HHAeXchange is highly preferred.

• Familiarity with EDI/837 claims, electronic remittance/835 files, clearinghouses, or payer billing portals is an advantage.

• An associate degree or further education/training in medical billing, healthcare administration, accounting, or a related field is preferred.

🏝️ Benefits

• Competitive salary and compensation packages.

• Opportunities for professional development and continuing education.

• Supportive work environment with a focus on teamwork and collaboration.

• Comprehensive health benefits and retirement plans.

• Additional perks and incentives to recognize employee contributions.