Billing Specialist

Nascentia Health•Syracuse, NY

8d•Onsite

About The Position

The Billing Specialist is responsible for accurate and timely processing of all claims, monthly billing and the collection and research of outstanding accounts receivable. This role ensures compliance with payer requirements and agency policies while supporting optimal reimbursement. Experience in Home Care billing and Article 28 is required. Experience with Home Care Home Base, Medent and HHA Exchange is preferred but not required.

Requirements

Minimum of 1-2 years of medical billing experience, preferably in home care.
Strong knowledge of revenue cycle management and accounts receivable processes.
Experience with PDGM, episodic billing, and institutional claims.
Familiarity with Medicare, Medicaid, and commercial insurance guidelines.
Excellent organizational, communication, and problem-solving skills.
Strong attention to detail and accuracy.
Dependable with a strong work ethic.
Commitment to excellent customer service.
Compliance with all agency policies and procedures.
Ability to communicate effectively, including speaking, hearing, and visual comprehension of written and verbal information.
Ability to sit or stand for extended periods (up to 90% of the workday).
Minimal risk; rare exposure to blood or body fluids.

Nice To Haves

Experience with Home Care Home Base, Medent and HHA Exchange is preferred but not required.
Experience with electronic billing systems and EDI platforms (e.g., Waystar) preferred.
Proficiency in Home Care Home Base and HHA Exchange preferred.

Responsibilities

Review and analyze claims for accuracy and completeness; obtain or correct missing or inaccurate information related to Home Health and Primary Care billing (PDGM, episodic, professional, institutional claims, and Article 28).
Prepare and submit claims/invoices to appropriate payers and clients within established billing schedules.
Ensure compliance with payer requirements, including Medicare, Medicaid, and commercial insurance guidelines.
Utilize electronic billing systems and EDI software (e.g., Waystar) to submit and track claims.
Monitor accounts receivable and perform timely follow-up on outstanding claims and invoices.
Research, resolve, and appeal unpaid or denied claims to maximize reimbursement.
Maintain accurate documentation of all billing and collection activities.
Post payments accurately and in a timely manner, maintaining a high level of accuracy, within 24 hours of receipt.
Identify and resolve discrepancies timely related to payments and billing.
Communicate billing, payment, and collection issues to the Billing Manager on an ongoing basis.
Collaborate with internal teams to resolve billing issues and improve processes.
Provide courteous, responsive, and professional customer service to clients, payers, and staff.
Utilize IT systems to perform job duties efficiently.
Adhere to all agency policies, procedures, and regulatory requirements.
Maintain current knowledge of Home Care and Primary Care billing practices and regulations.
Attend required meetings, trainings, and workshops.
Foster open communication and contribute to a team-oriented work environment.
Support agency initiatives related to planning and problem-solving.