Billing Specialist (Full-Time)

Job Description

Job Description

About the Role

We are seeking a detail-oriented Billing Specialist to join our Home Health team. This is a remote position open only to candidates residing in California or Nevada. The Billing Specialist will support our clinicians and operations by managing accurate and timely billing processes for Medicare, Medi-Cal, Managed Care, and commercial payers. This role ensures compliance with PDGM guidelines and payer requirements , helping maintain smooth revenue cycles and supporting high-quality patient care.

Responsibilities

Prepare and submit accurate home health claims to Medicare, Medicaid, and private payers.

Verify billing details, including physician orders, OASIS documentation, visit notes, and authorization requirements.

Track accounts receivable and follow up on unpaid or denied claims, including resubmissions and appeals.

Communicate with patients, clinicians, and insurance representatives to resolve billing inquiries.

Maintain accurate billing records and stay current with payer rules and regulatory updates.

Collaborate with intake and medical records to ensure documentation is complete before billing.

Minimum Qualifications

High school diploma or equivalent; associate degree in healthcare administration or related field preferred.

2+ years of experience in medical billing, preferably in home health or hospice.

Familiarity with home health EHR / billing systems

Strong understanding of Medicare / Medicaid billing, PDGM, OASIS, CPT / ICD-10 coding.

Excellent organizational and communication skills with high attention to detail.

Preferred Qualifications

Certification (e.g., CPB, CMRS) a plus.

Experience with multiple payers, including Managed Care.

Knowledge of denial management and billing audits.

Benefits

Remote position (work from home).

Medical, dental, and vision insurance.

401(k) with employer match.

Paid Time Off (PTO) + holidays.

Supportive, collaborative team environment.