Billing Specialist Urgently Hiring

Benefits:401(k)Flexible scheduleParental leaveMinimum 3 years' experience in billing and claimsPosition SummaryThe Billing & Credentialing Specialist is responsible for managing all aspects of medical billing, Medicaid claims processing, long-term care billing, provider credentialing, and weekly invoicing. This role ensures timely and accurate reimbursement, regulatory compliance, and proper maintenance of payer contracts and provider enrollments.The ideal candidate demonstrates strong attention to detail, knowledge of healthcare billing systems, and the ability to meet strict deadlines.Primary ResponsibilitiesMedicaid Billing & Claims ManagementSubmit accurate Medicaid claims in accordance with state guidelines.Monitor claim status and resolve denials, rejections, and underpayments.Ensure proper coding and documentation compliance.Reconcile payments and post remittances accurately.Maintain knowledge of NCTracks (or applicable state Medicaid portal).Communicate with Medicaid representatives as needed.Long-Term Care (LTC) BillingProcess and submit long-term care billing claims.Verify patient eligibility and authorization requirements.Coordinate with case managers and facility administrators.Reconcile LTC payments and manage outstanding balances.Maintain documentation to support claims and audits.Provider CredentialingComplete initial and re-credentialing applications for Medicaid, managed care plans, and other payers.Maintain provider enrollment records, NPIs, CAQH profiles, and state licenses.Track credentialing expiration dates and ensure timely renewals.Submit and follow up on payer contracts and amendments.Maintain compliance with federal and state healthcare regulations.Weekly InvoicingGenerate and send weekly invoices to:Private pay clientsManaged care organizationsTransportation brokers (if applicable)Verify service logs on Carescout LTC or LTC before invoicing.Track payments and follow up on outstanding balances.Maintain accurate accounts receivable records.Reporting & CompliancePrepare weekly billing reports for leadership.Maintain HIPAA compliance and protect confidential information.Assist with audits and documentation requests.Identify billing trends and recommend process improvements.QualificationsMinimum 2–3 years healthcare billing experience (Home Care, NEMT, or LTC preferred)Experience with Medicaid billing (NC preferred)Knowledge of long-term care billing proceduresExperience with provider credentialingProficiency in billing software and EMR/EVV systemsStrong knowledge of HIPAA regulationsExcellent attention to detail and organizational skillsStrong written and verbal communication skillsThis Independent Contractor Agreement may be terminated at any time, with or without cause, by either party upon written or verbal notice.● Sky Heart Home Care Services reserves the right to terminate this agreement immediately, without notice, for any of the following, including but not limited to:● Breach of confidentiality● HIPAA violations● Misrepresentation of services● Failure to perform assigned duties● Insubordination or unprofessional conduct● Fraud, theft, or misconduct● Conflict of interest● Non-compliance with policies● Damage to company reputationUpon termination:● Contractor access to all systems, records, and files will be immediately revoked● All company property must be returned within 24 hours● Final compensation will be issued only for approved completed workBecause this position is classified as an Independent Contractor (1099):● No unemployment insurance is paid by Sky Heart● Contractor is NOT eligible for North Carolina unemployment benefits● Contractor waives any right to file for unemployment compensation● Any unemployment claim filed will be formally disputed by Sky Heart with documentation of 1099 statusPerformance ExpectationsClaims submitted within required timelinesDenial rate maintained below company benchmarkCredentialing renewals completed before expirationWeekly invoices sent on time without errorsAccurate reporting and reconciliation

Created: 2026-03-04