Home Care Billing Specialist

Polaris Healthcare•Spring Valley, NY

12d

About The Position

We are seeking a detail-oriented, organized, and experienced LHCSA Biller to join a growing home care team in Spring Valley, New York. This full-time role supports the agency’s financial operations by ensuring services provided to patients are billed accurately and efficiently. The position involves preparing and submitting claims, monitoring payments, resolving billing discrepancies, and maintaining compliance with New York State Medicaid and payer requirements. The Home Care Billing Specialist processes billing for home care services and works with Medicaid, Managed Long-Term Care (MLTC) plans, and other contracted payers. The role also involves accounts receivable follow-up, payment reconciliation, billing documentation, audit support, and collaboration with scheduling, coordination, payroll, and clinical departments. The schedule is Monday through Friday, and the stated pay rate is $25.00 per hour. Benefits are available based on company policy.

Requirements

Previous medical billing experience, preferably within a Licensed Home Care Services Agency (LHCSA).
Knowledge of Medicaid and Managed Long-Term Care (MLTC) billing.
Understanding of home care billing procedures, claims submission, and reimbursement processes.
Experience working with Electronic Visit Verification (EVV) systems.
Strong attention to detail and organizational skills.
Proficiency in Microsoft Excel and general computer applications.
Ability to manage multiple priorities and meet billing deadlines.
Strong communication and problem-solving skills.

Nice To Haves

1–2 years of home care billing experience.
Experience with HHAeXchange or similar home care management software.
Familiarity with electronic claims submission, payment posting, and denial management.
Knowledge of New York State home care billing regulations.
Experience working with multiple MLTC plans and payer portals.

Responsibilities

Prepare, review, and submit accurate claims to Medicaid, MLTC plans, and other contracted payers.
Process daily, weekly, and monthly billing for home care services.
Verify service authorizations, approved hours, and billing rates before claim submission.
Submit claims within payer deadlines.
Reconcile billed hours against caregiver timesheets and EVV records.
Identify and correct billing discrepancies, rejected claims, and denials.
Process corrected claims and follow up on outstanding reimbursements.
Monitor outstanding accounts receivable and follow up on unpaid claims.
Review payment remittances and identify underpayments or discrepancies.
Maintain accurate billing records and payment documentation.
Assist with monthly billing reconciliation and reporting.
Work to reduce claim denials and improve reimbursement turnaround times.
Ensure billing practices comply with applicable New York State Medicaid, MLTC, EVV, and HIPAA requirements.
Maintain accurate documentation to support claims and audits.
Monitor changes to payer billing guidelines and reimbursement requirements.
Assist with internal and external billing audits as needed.
Work with scheduling, coordination, payroll, and clinical departments to resolve billing issues.
Communicate with insurance providers and MLTC plans regarding claims, authorizations, and payments.
Identify recurring billing issues and recommend improvements to increase efficiency and accuracy.