Billing Specialist

Accountabilities:

Manage the complete billing cycle by generating, reviewing, and submitting claims to insurance companies, government programs, and other healthcare payers for services delivered to patients.
Use agency management and billing software to process claims accurately and efficiently across multiple home care agencies.
Record, post, and reconcile payments received from insurance providers, patients, and other sources within the appropriate billing systems.
Monitor accounts receivable, follow up on unpaid claims, investigate rejected or denied submissions, and manage outstanding balances to support timely collections.
Research and resolve billing discrepancies, payment issues, and claim denials to maximize reimbursement and minimize revenue delays.
Communicate and collaborate with insurance providers and other payers to resolve claim disputes and facilitate payment processing.
Apply knowledge of home health agency operations, including healthcare information exchange requirements, industry regulations, and applicable compliance standards.
Perform regular accounts receivable reconciliations to identify discrepancies between recorded balances and payments received.
Work closely with internal departments and external agency partners to address billing challenges, improve communication, and streamline revenue cycle processes.
Prepare and maintain billing and accounts receivable reports, tracking key performance indicators (KPIs) and operational metrics.
Communicate effectively with colleagues and management to provide updates, share insights, and support team objectives.
Develop and maintain a strong understanding of customer needs, business objectives, and operational priorities.
Undertake additional responsibilities as assigned by the supervisor or management team.
Be available for occasional business travel, including overnight trips, of up to 10%.
Requirements:
High school diploma or equivalent required; an associate's or bachelor's degree in healthcare administration, finance, or a related discipline is preferred.
At least 3 years of revenue cycle management (RCM) experience, preferably within the home care or home health industry.
Strong understanding of medical billing procedures, insurance payments, claims processing, reimbursement practices, and accounts receivable management.
Familiarity with home health agency operations, healthcare information exchange processes, and relevant regulatory and compliance requirements.
Proficiency in Microsoft Office applications and Microsoft Teams.
Strong written and verbal communication skills, with the ability to interact professionally with internal teams, healthcare agencies, and external payers.
Excellent analytical, critical-thinking, and problem-solving abilities, particularly when investigating billing discrepancies and resolving claim denials.
Exceptional attention to detail and organizational skills, ensuring accuracy across high-volume billing and payment processes.
Ability to manage multiple priorities, meet deadlines, and perform effectively in a fast-paced environment.
A strategic and creative mindset, with the ability to identify process improvements and develop practical solutions.
Self-motivated and proactive approach, combined with a strong ability to collaborate and contribute to team success.
Ability to work independently while maintaining effective communication with colleagues and management.
Willingness to travel up to 10%, including occasional overnight stays.
Ability to perform the essential responsibilities of the position with or without reasonable accommodations.
Benefits:
Hourly compensation: $22.00–$24.00 per hour, depending on experience, education, training, qualifications, location, and other relevant factors.
Comprehensive and competitive healthcare insurance plans.
Paid time off (PTO) to support work-life balance.
Company-paid holidays.
401(k) retirement savings plan with an employer-selected matching contribution.
Additional company-sponsored benefit and wellness programs.
Remote working opportunities for candidates based in Eastern and Central time zones.
Hybrid working arrangements for candidates located near the Midtown Manhattan, New York, or Bloomington, Minnesota offices, with an expected on-site presence three days per week.