Medical Billing & Accounts Receivable Specialist

Job Description

Job Description

Medical Biller – Home Care / Medicaid

Company: Aluma Home Care
Location: Valley Stream, NY
Job Type: Full-Time

About Aluma Home Care

Aluma Home Care is a growing home care agency providing quality, non-medical home care services throughout Ohio. We are expanding rapidly and looking for an experienced, detail-oriented Medical Biller to join our team.

We are seeking someone who takes ownership of the billing process, proactively resolves issues, and ensures claims are submitted accurately and payments are collected promptly.

Job Description

The Medical Biller will be responsible for managing the day-to-day billing and collections process, including claim submission, payment posting, denial management, accounts receivable follow-up, and reconciliation.

The ideal candidate has experience with Medicaid and managed care billing, understands the revenue cycle, and is comfortable investigating and resolving complex billing issues independently.

Key Responsibilities

• Prepare, review, and submit medical claims accurately and on time.

• Manage billing for Medicaid and managed care organizations (MCOs).

• Monitor claim status and proactively follow up on unpaid, rejected, or denied claims.

• Investigate billing discrepancies, identify root causes, and implement solutions.

• Review remittance advice (ERA/EOB) and accurately post payments and adjustments.

• Manage accounts receivable (A/R), including aging reports and outstanding balances.

• Work directly with insurance companies to resolve claim issues and secure timely reimbursement.

• Reconcile billed services against authorizations, service records, and payments.

• Identify and correct billing errors involving authorizations, eligibility, coding, and electronic claim submissions.

• Collaborate with the operations team to resolve documentation and billing discrepancies.

• Maintain accurate billing records and prepare regular reports on collections, denials, and outstanding claims.

• Continuously improve billing processes to reduce denials and accelerate collections.

Qualifications

Required:

• Minimum 2 years of experience in medical billing, preferably Medicaid or managed care.

• Strong understanding of the medical billing and revenue cycle process.

• Experience with electronic claims submission, denial management, and A/R follow-up.

• Ability to independently troubleshoot and resolve billing issues.

• Strong attention to detail, organizational skills, and follow-through.

• Proficiency with billing software, payer portals, and Microsoft Excel.

• Excellent communication and problem-solving skills.

Preferred:

• Experience billing for home care, home health, or personal care services.

• Familiarity with Ohio Medicaid and managed care organizations, including CareSource, Buckeye Health Plan, Molina, and other Ohio payers.

• Experience with KanTime, Inovalon, or similar billing platforms.

• Knowledge of electronic visit verification (EVV), service authorizations, and Medicaid waiver programs.

• Familiarity with electronic claims (837), remittance files (835), and clearinghouse rejection resolution.

What We're Looking For

We're looking for more than someone who simply submits claims.

We want a proactive, resourceful individual who takes ownership of the entire billing process, follows through until issues are resolved, and understands the importance of timely and accurate collections.

The right candidate is analytical, persistent, organized, and comfortable working in a fast-growing company where processes are continuously evolving.

Why Join Aluma Home Care?

• Join a rapidly growing home care organization.

• Opportunity to take ownership of an important business function.

• Work directly with management and have a meaningful impact on company performance.

• Collaborative, professional work environment.

• Opportunities for growth as the company expands.