We are seeking an experienced Medical Billing Specialist with a strong background in New York State Home Care billing. The ideal candidate must have extensive experience billing LHCSA services and be proficient with HHAeXchange, eMedNY, and payer portals.This position is responsible for ensuring accurate claim submission, timely collections, payment posting, denial management, and maximizing reimbursement while maintaining full compliance with New York State Department of Health and payer requirements.ResponsibilitiesPrepare, review, and submit claims for:
- MLTC / CHHA / NHTD / TBI / Medicaid Fee-for-Service
- Process billing through HHAeXchange.
- Submit and monitor claims through eMedNY and payer portals.
- Verify authorizations, eligibility, plans of care, and visit documentation prior to billing.
- Review EVV compliance and resolve visit exceptions.
- Work HHAeXchange Exception Reports daily to ensure all visits are billable.
- Identify and correct billing edits, rejected claims, and denied claims.
- Research and resolve claim denials, partial payments, and underpayments.
- Post payments and contractual adjustments accurately.Reconcile remittance advices (835s/EOBs) with submitted claims.
- Coordinate with Scheduling, Authorizations, Clinical, Payroll, and Intake departments to resolve billing issues.
- Maintain compliance with all Medicaid, MLTC, DOH, and payer billing regulations.
- Assist with month-end billing close and Accounts Receivable reporting.
Required Qualifications
- Minimum 3 years of New York Home Care billing experience.
- Experience billing: LHCSA, MLTC, CHHA, NHTD, TBI.
- Advanced knowledge of HHAeXchange.
- Experience using eMedNY.
- Experience working with Medicaid billing regulations.
Preferred QualificationsExperience with one or more of the following:
- Ability Network
- Office Ally
- Availity
- Medicare and Medicaid Remittance Advice interpretation
- Excel
Job Type: Full-time
Pay: $50,000.00 - $80,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Experience:
- HHA Exchange : 1 year (Required)
- New York Home Care billing: 3 years (Required)
- LHCSA, MLTC, CHHA, NHTD, TBI: 1 year (Required)
- eMedNY: 1 year (Required)
- Medicaid billing regulations: 1 year (Required)
Ability to Commute:
- Brooklyn, NY 11235 (Required)
Work Location: In person
