Billing Specialist

Benefits : 401(k)

Dental insurance

Health insurance

Training & development

Vision insurance

We are looking for a Medical Billing Specialist responsible for completing the billing process from claim generation through payment, ensuring accounts receivable are accurate and up to date for all payer sources. This position troubleshoots and resolves billing issues and ensures a smooth, compliant billing process.

Qualifications

High school diploma required; college degree preferred

Minimum two (2) years of experience, preferably in a healthcare or home health setting

Knowledge of billing regulations, prior authorizations, medical terminology, and coding for Medicare, Medicaid, and insurance

Understanding of home health reimbursement regulations and standards

Strong verbal, written, and interpersonal communication skills

Proficient in Microsoft Word and Excel

Ability to organize, prioritize, and manage time effectively with minimal supervision

Skilled in problem-solving, decision-making, and conflict resolution

Able to create standard operating procedures and work in a regulated environment

Demonstrates professionalism and teamwork

Licensed driver with insured vehicle per agency and state requirements

Essential Functions / Areas of Accountability

Billing and Accounts Receivable

Perform billing for all payer sources in compliance with Agency, State, and Federal regulations

Bill all payers accurately, including Medicaid PA, Aged and Disabled Waiver, Thrive Alliance Choice, CICOA Choice, LifeSpan, Private Pay, and all other accepted insurance types

Track Medicare claims and coordinate with Billing and Medical Staff to ensure payment

Post all payments accurately and promptly

Monitor and reconcile accounts receivable to maintain current balances

Review and complete back-billing for Medicaid claims by the 15th of each month for the prior month

Generate and distribute claims and invoices as required

Post adjustments and approved write-offs accurately

Send late notices to Private Pay customers and report accounts over 90 days to collections and Supervisor

Notify Supervisor of billing discrepancies, including coding errors, authorization limits, or credentialing issues

Communicate with scheduling and data entry staff to resolve coding or authorization issues affecting payments

Maintain accurate billing reports and documentation, including spreadsheets, A / R summaries, and payer credentialing updates

Collaborate with clinical, scheduling, auditing, and management teams to ensure efficient billing operations