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About the Role

The Home Health Billing Professional I is responsible for supporting the revenue cycle by ensuring the accurate and timely processing of home health claims, payments, and collections. This role focuses on resolving claim rejections and denials, reconciling payments, managing payer communications, and maintaining compliance with billing regulations and payer requirements. Working closely with both clinical and operational teams, the position helps drive clean claim submission, timely reimbursement, and overall financial performance through proactive follow-up and effective account management.

Responsibilities

Submit and manage home health claims accurately and timely.
Work clearinghouse rejections daily by researching issues, correcting errors, and resubmitting claims until fully processed and paid.
Track and resolve claim edits, denials, and reason codes, including duplicate claims, overlap issues, and provider/facility-related edits.
Reconcile claims, payments, and adjustments from 835 files and escalate unresolved variances or denials.
Manage Managed Care and commercial claims through payer portals and clearinghouses, making corrections and resubmissions as necessary.
Collaborate with Clinical Intake, Coding, QA, and Clinical Operations teams to ensure billable readiness, including signed orders, completed visit documentation, locked OASIS assessments, and supporting clinical documentation.
Monitor and prevent late claims while documenting root causes and request exceptions when appropriate.
Maintain organized worklists, aging reports, and account follow-up notes with clear next steps.
Safeguard patient health information (PHI) and comply with CMS regulations, payer requirements, and company policies.

Requirements

2+ years of healthcare billing and collections experience with hands-on DDE FISS experience.
Strong knowledge of denials management, CARC codes, revenue codes, HCPCS codes, and Type of Bills (TOBs).
Experience researching and resolving claim rejections and billing edits.
Knowledge of EDI transactions, including 837I, 835, 276/277, and 999 files.
Experience working with Managed Care payer portals.
Strong attention to detail, sense of urgency, and commitment to accurate claim submission.
Excellent written documentation and organizational skills.
Experience with McKesson, WellSky a plus.
Basic Excel skills for tracking KPIs, productivity, and aging reports.

Skills

DDE FISS
Denials management
CARC codes
Revenue codes
HCPCS codes
Type of Bills (TOBs)
EDI transactions
837I
835
276/277
999 files
Managed Care payer portals
Attention to detail
Sense of urgency
Accurate claim submission
Written documentation
Organizational skills
McKesson
WellSky
Excel
KPI tracking
Productivity tracking
Aging reports

Location

New Hyde Park

Work Type

On-Site

Experience Level

2+ years

Salary/Compensations

$25.00 to $29.00 Hourly

Benefits

Health
Dental
Vision
Life Insurance
401k + Company match
Paid holidays
PTO package
Paid orientation
Employee Referral Program

About the Company

Extended Home Care is seeking an experienced Billing Specialist to work at our New Hyde Park location.

Equal Opportunity

We are an equal opportunity employer. We do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, genetic information, or any other protected characteristic under federal, state, or local law. Reasonable accommodation is available per ADA and applicable state laws.