Billing Specialist-Homecare

Job Description

Overview

Community Based Care, LLC is seeking a dedicated and experienced Billing Specialist to

manage all aspects of billing, payment posting, denial management, and the verification of

authorizations and service agreements for our home care services. The ideal candidate will have a strong background in home care billing, exceptional attention to detail, and a proactive approach to problem-solving.

We are looking for someone with homecare billing expereince.

Responsibilities

Key Responsibilities :

1. Billing :

o Prepare and submit accurate, timely claims to Medicaid, MCOs, and other payers

for home care services.

o Ensure strict compliance with all relevant billing regulations and guidelines.

o Maintain comprehensive records of billing activities and patient accounts.

2. Denials Management :

o Analyze denied claims to identify root causes and execute corrective actions to

prevent future denials.

o Resubmit corrected claims and provide supporting documentation for claim

appeals.

o Liaise with insurance companies to resolve outstanding issues and secure

payments.

3. Payment Posting :

o Accurately post payments received from insurance companies and patients to the

appropriate accounts.

o Reconcile accounts to ensure all payments are accounted for, promptly resolving

any discrepancies.

4. Authorization :

o Verify service agreements and authorizations received from payors.

o Accurately enter authorizations into our EMR / billing system.

o Ensure all authorizations are correct and up to date.

5. Reporting and Analysis :

o Generate regular reports on billing activities, payment status, and denial trends.

o Provide insights and recommendations to improve billing processes and reduce

denials.

Qualifications :

Minimum of 2-3 years of experience in medical billing, specifically in home care

services.

Experience with PCA billing.

Proficiency in billing software (e.g., WellSky) and electronic health records (EHR)

systems.

Strong understanding of insurance policies, procedures, and regulations related to home

care billing.

Experience with Minnesota home care billing is preferred.

Excellent analytical skills, with the ability to identify trends and issues in billing and

denial data.

Strong communication skills, both written and verbal, for effective interaction with

insurance companies and team members.

High degree of accuracy and attention to detail in all aspects of work.

Ability to work independently and manage multiple tasks simultaneously.

Skills :

Advanced proficiency in MS Office, particularly Excel.

Familiarity with ICD-10, CPT, and HCPCS coding.

Knowledge of HIPAA regulations with the ability to maintain patient confidentiality.

Strong problem-solving skills and critical thinking abilities.

Qualifications

High school diploma or equivalent required; an associate or bachelor’s degree in

healthcare administration, finance, or a related field is preferred.