Home Health Billing Specialist

Salary: $7/hr - $8/hr

*****IMPORTANT*****

To apply, kindly fill out this form: https://forms.integratedhire.com/t/v4Co5va8cbus

Note: Applicants that don't apply directly will not be considered

Overview

We are seeking a highly organized and experienced Home Health Billing Specialist to support billing operations, quality assurance workflows, documentation review, claims management, and operational coordination.

This role requires strong home health billing knowledge, understanding of Medicare and CMS compliance requirements, experience working with clinical documentation and OASIS workflows, and the ability to collaborate closely with agency leadership, clinical staff, and operations.

The ideal candidate is proactive, detail-oriented, highly responsive, and capable of balancing both billing and quality assurance responsibilities while supporting operational efficiency, compliance readiness, and an exceptional patient experience.

• Verify patient insurance coverage and eligibility for home health services.
• Confirm payer benefits, authorizations, referrals, and coverage requirements.
• Prepare and submit Medicare, Medicaid, and private insurance claims accurately and timely.
• Ensure claims meet payer guidelines and agency billing requirements.
• Utilize WellSky/Kinnser or similar EMR systems for billing workflows and claim management.
• Assign and review appropriate ICD-10 diagnosis codes and applicable CPT/HCPCS procedure codes.
• Ensure documentation supports billed services and coding accuracy.
• Post insurance and patient payments accurately.
• Reconcile accounts and review Explanation of Benefits (EOBs).
• Monitor unpaid claims and aging reports.
• Perform accounts receivable follow-up and communicate with payers regarding delayed payments.
• Review denied or rejected claims and identify root causes.
• Correct billing errors, submit appeals, and resubmit corrected claims.
• Assist with denial prevention strategies and reimbursement optimization.
• Generate billing, reimbursement, and revenue cycle reports.
• Track outstanding balances, reimbursement trends, and operational billing metrics.
• Assist with ensuring documentation readiness for claims processing and billing submission.

• Review patient charts and clinical documentation for completeness, accuracy, and operational readiness.
• Ensure visit notes, care plans, and physician documentation meet Medicare and agency requirements.
• Review OASIS assessments for accuracy and consistency with supporting clinical documentation.
• Identify documentation inconsistencies, coding discrepancies, or missing information that may impact reimbursement, compliance, or quality metrics.
• Assist with pre-billing audits, admission audits, recertification audits, discharge audits, and internal compliance reviews.
• Identify missing signatures, incomplete notes, invalid diagnoses, and workflow delays.
• Ensure physician orders and required documentation are signed and completed timely.
• Support internal quality assurance workflows and compliance readiness.
• Assist with ensuring documentation aligns with PDGM requirements and CMS regulations.
• Collaborate with leadership and clinical staff to improve documentation quality and workflow efficiency.
• Support quality improvement initiatives related to patient outcomes, hospitalization rates, HHCAHPS scores, and operational performance.
• Assist with survey and audit preparation activities as needed.

• Coordinate with nurses, therapists, physicians, intake staff, and agency leadership regarding documentation and workflow needs.
• Assist with obtaining missing clinical documentation and physician signatures.
• Support operational workflows from referral through billing readiness.
• Monitor pending items and follow up proactively to ensure workflow progression.
• Utilize critical thinking skills to identify operational bottlenecks and escalate concerns appropriately.
• Maintain organized tracking systems for claims, authorizations, appeals, and pending orders
• Assist with insurance coordination and authorization-related workflows as needed.
• Collaborate closely with the Director of Operations and clinical leadership team.
• Support administrative and operational tasks during workflow bottlenecks.
• Maintain professionalism, confidentiality, responsiveness, and a strong team-oriented approach.

• Ensure compliance with CMS regulations, Conditions of Participation (CoPs), HIPAA standards, and applicable state licensing requirements.
• Maintain understanding of Medicare home health billing regulations and reimbursement requirements.
• Ensure OASIS documentation aligns appropriately with billing and compliance requirements.
• Support agency efforts focused on reducing audit risk, denials, fines, and compliance-related issues.
• Maintain accurate and organized documentation within the agency EMR system.

• Minimum three years of home health billing or revenue cycle experience required.
• Prior experience supporting U.S.-based home health agencies required.
• Strong understanding of Medicare home health billing workflows, PDGM, RAP/NOA processes, and OASIS documentation requirements.
• Experience working with WellSky/Kinnser or similar home health EMR systems preferred.
• Knowledge of ICD-10, CPT, and HCPCS coding.
• Strong understanding of physician orders, documentation workflows, and claims processing.
• Excellent critical thinking and problem-solving abilities.
• Strong organizational and multitasking skills.
• Excellent verbal and written English communication skills.
• Ability to work independently while remaining highly collaborative with leadership and staff.
• Strong attention to detail and ability to proactively identify workflow issues.
• Strong computer skills and familiarity with spreadsheet tracking and electronic claims systems.
• Comfortable working in a fast-paced remote environment.
• Highly responsive and dependable during scheduled working hours.

• Certified Professional Biller (CPB), Certified Coding Associate (CCA), or Certified Home Health Coding Specialist (HCS-D) certification preferred.
• Experience supporting both billing and QA workflows in a home health setting.
• Experience with denial management, appeals, and reimbursement recovery.
• Familiarity with patient-centered care coordination and home health operations.
• Experience supporting small to mid-sized home health agencies.
• Experience working in collaborative remote healthcare teams.
• Ability to support operational process improvement initiatives.
• Familiarity with Texas home health workflows and physician coordination processes.
• Experience utilizing AI-assisted tools or workflow systems to support QA or documentation review processes.

What we offer:

• Competitive compensation — $7–$8 per hour, paid in USD
• Fixed U.S. working schedule
• Fully remote role — work from anywhere
• Direct collaboration with U.S. small businesses and entrepreneurs
• Paid time off — 10 PTO days per year, plus 6 U.S. holidays off