Home Health Billing and Accounts Receivable (A/R) Specialist (Availity)

This is a remote position.

Job Summary

RCM Staff BPO is hiring a full-time Home Health Billing and Accounts Receivable (A/R) Specialist to support a revenue cycle company serving home care agencies based in Illinois.

The specialist will submit and correct claims, resolve denials with Medicaid managed care plans, reconcile payments, and follow up on aged A/R across multiple agency accounts, using Availity every day. This role requires strong attention to detail, consistent follow-up, and hands-on home health billing experience with Medicaid managed care plans.

Key Responsibilities

* Verify Medicaid eligibility, payer assignment, authorizations, service codes, and approved units

* Submit clean claims to Medicaid managed care plans and commercial payers, correct rejections, and submit corrected claims

* Use Availity daily for eligibility, claim status, remittances, denials, and payer inquiries

* Investigate and resolve denials and underpayments, including appeals and payment disputes

* Follow up on unpaid and aged A/R by payer portal and phone, and track timely filing deadlines

* Post and reconcile ERAs and EOBs against expected reimbursement

* Reconcile visits, authorized units, and billed units to catch unbilled or incorrectly billed services

* Prepare A/R aging, denial, and collections reports in Excel or Google Sheets

* Document all account activity clearly and escalate payer issues to the team lead

* Protect patient information and follow HIPAA requirements

Qualifications

* At least 2 years of U.S. home health billing experience

* Strong, hands-on Availity experience, including claim status, remittances, and denials

* Experience billing Medicaid managed care plans (MCOs)

* Proven experience in denial management and A/R follow-up

* Familiarity with commercial insurance and government health plans

* Strong Excel or Google Sheets skills

* Strong written and spoken English, including payer calls and written disputes

* Excellent attention to detail and follow-up skills

* Ability to work independently and manage multiple agency accounts

* Reliable internet connection and a suitable remote workspace

Preferred Qualifications

* Experience billing nonmedical home care, personal care, or HCBS waiver services

* Familiarity with Illinois Medicaid and Illinois Medicaid MCOs such as Aetna Better Health, Blue Cross Community Health Plans, Molina, Meridian, or CountyCare

* Experience using HHAeXchange, AxisCare, CareSmartz360, CareTime, or Axxess
* Experience with EVV visit reconciliation and authorization tracking

Schedule

* Full-time position

* Must be available during Central Time business hours

* Final schedule will be determined based on client needs

Work Arrangement

* Remote

* Philippines-based applicants preferred