Billing Specialist

About This Role

The Billing Specialist manages the Nebraska Medicaid Waiver and VA billing process for a home care agency. This role focuses on submitting claims, resolving billing issues, maintaining billing compliance, and collaborating with internal teams and payer partners to ensure accurate and prompt payment for services. It suits a detail-oriented and organized individual who enjoys problem-solving and process improvement.

Responsibilities

• Submit Medicaid Waiver claims through Netsmart and VA Community Care claims through Optum
• Review visits, authorizations, and documentation for billing accuracy
• Resolve claim denials, rejected visits, billing exceptions, and payment delays
• Monitor Electronic Visit Verification (EVV) compliance and assist with Force Pay requests when needed
• Coordinate with Scheduling, Client Care, Recruiters, Care Professionals, and Billing to obtain required documentation
• Communicate with Netsmart, Nebraska DHHS, Optum, VA representatives, and other payer contacts to resolve billing issues
• Submit weekly IVR phone approval requests for eligible Medicaid clients
• Track billing performance, collections, and outstanding claims while identifying opportunities to improve reimbursement and efficiency
• Assist with Long-Term Care Insurance billing inquiries and support the billing team as needed
• Perform other related duties as assigned

Requirements

• High school diploma or equivalent
• Strong computer skills, including Microsoft Office
• Excellent organization, attention to detail, and communication skills
• Ability to prioritize multiple tasks and work both independently and as part of a team

Nice to have:

• Healthcare billing experience
• Experience with Medicaid, VA Community Care, or home care billing
• Familiarity with Netsmart, Optum, Well Sky, or similar healthcare software
• Knowledge of Electronic Visit Verification (EVV)

Benefits

• Health, dental, and vision insurance
• Paid Time Off (PTO) and paid holidays
• Retirement savings opportunities
• Ongoing training and professional development
• Career growth opportunities
• Supportive team environment
• The opportunity to work for a Forbes Best Place to Work for three consecutive years

About the Company

Right at Home is a locally owned home care agency serving seniors, veterans, and adults with disabilities throughout Northeast and Central Nebraska. Its mission is to improve the quality of life for those it serves, providing exceptional care and an outstanding workplace for its employees. The company has been recognized as a Forbes Best Place to Work for three consecutive years.