Billing Coordinator - Home Healthcare

The Billing Coordinator is responsible for ensuring the accurate and timely preparation, submission, and follow-up of Medicaid and managed care claims for in-home and Consumer Directed Services (CDS). This position plays a vital role in maintaining the financial integrity of the organization by ensuring compliance with funder and state requirements while providing exceptional service to internal departments and external partners.
The ideal candidate is detail-oriented, organized, and thrives in a fast-paced environment where deadlines, accuracy, and professionalism are critical.

Key Responsibilities:

• Prepare and submit Medicaid/MCO claims for Missouri, Illinois, and Tennessee.

• Verify authorizations, eligibility, and service codes before claim submission.
• Research, correct, and resubmit denied or rejected claims.
• Post and reconcile payments from Medicaid, MCO (Managed Care Organizations), VA, and DMH (Dept. of Mental Health)
• Maintain accurate A/R records and follow up on unpaid or denied claims.
• Communicate professionally with funders to resolve billing issues and clarify payments.
• Audit billing documentation for completeness and compliance with payer requirements.
• Collaborate with intake, payroll, and service coordination departments to ensure data accuracy.
• Support internal audits and maintain HIPAA confidentiality standards.

• Healthcare or Home Care Billing: At least one year of experience in healthcare or home care billing.

• Medicaid and MCO Billing: Working knowledge of Missouri, Illinois, and Tennessee Medicaid/MCO billing processes.

• VA and DMH Billing: Experience handling Veterans Affairs and Department of Mental Health billing and authorizations.

• Payment Posting: Skilled in posting and reconciling payments with funder and client records.

• Accounts Receivable (AR) Management: Proficient in managing A/R, following up on denials, and resolving discrepancies efficiently.

• Funder Communication: Experience interacting professionally with funders to resolve claim issues, obtain authorizations, and clarify payments.

• Claim Research & Denial Resolution: Demonstrated ability to investigate and correct billing errors, reprocess denied claims, and follow up to ensure resolution and payment.

• Electronic Health Records (EHR): Hands-on experience using electronic billing platforms and health record systems.

• Compliance and Documentation Management: Experience ensuring all billing records meet regulatory and payer compliance standards.

• Cross-Department Collaboration: Proven success working closely with internal departments to streamline billing accuracy.

Full Benefits Package including: ETO, Holiday Pay, Health, Dental, and Life Insurance. The pay ranges from $17/hr. to $19/hr. depending on experience and background.