Home Care Billing Specialist

4 days ago


Cranston, Rhode Island, United States A Homely Care LLC Full time

A Homely Care LLC seeks an experienced Home Care Billing Specialist to support our billing management team. This role plays a crucial part in ensuring timely financial processing, monitoring client insurance status, and identifying changes promptly. The ideal candidate has hands-on experience with home care billing software, including Axxess for caregiver clock-ins and Inovalon for claims submission and eligibility verification.

Key Responsibilities
  • Daily billing and issue detection: Perform daily billing to ensure timely financial processing and catch any client insurance changes, such as plan transitions or coverage terminations.
  • Electronic Visit Verification (EVV) oversight: Monitor EVV accuracy in Axxess, ensuring the accuracy of caregiver work hours and quality care delivery.
  • Prior authorization management: Verify and maintain prior authorizations for required services, ensuring accurate documentation for medical necessity.
  • Claims submission and processing: Use Inovalon to submit and manage claims, including eligibility checks and claim status updates.
  • Insurance eligibility checks: Conduct regular insurance eligibility checks using Navinet and the Rhode Island Provider Portal.

The estimated salary for this position is $60,000 - $80,000 per year, depending on experience and qualifications. Benefits include a comprehensive benefits package, including medical and dental coverage, starting in 2025.



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