Accounts Receivable Specialist with PDGM experience in Home Health

3 days ago

Philippines Portiva Full time ₱720,000 - ₱780,000 per year

We are seeking a detail-oriented and experienced Accounts Receivable Specialist with expertise in home health billing under PDGM (Patient-Driven Groupings Model). The AR Specialist will be responsible for managing collections, payment posting, denial resolution, and maintaining accurate accounts receivable records to ensure timely reimbursement from Medicare, Medicaid, and commercial payers.

Key Responsibilities:

  • Claims Follow-Up: Monitor submitted PDGM claims to ensure timely processing and payment.
  • Collections: Contact payers for unpaid or underpaid claims, resolve discrepancies, and escalate issues when necessary.
  • Payment Posting: Accurately post ERA/EOB payments into the billing system and reconcile deposits.
  • Denial Management: Analyze denials (clinical, coding, OASIS-related, LUPA, NOA/NOE errors), correct and resubmit claims.
  • Reconciliation: Compare payments received against expected PDGM reimbursement rates and correct variances.
  • Reporting: Maintain AR aging reports, track collection metrics, and provide regular updates to management.
  • Collaboration: Work with billing, intake, and clinical teams to resolve documentation or coding issues affecting payments.
  • Compliance: Ensure adherence to Medicare, Medicaid, and commercial payer billing regulations.

Qualifications:

  • Minimum 2 years of experience in home health billing/collections, preferably with PDGM knowledge.
  • Strong understanding of Medicare and Medicaid billing regulations, NOA/NOE, and PDGM reimbursement.
  • Proficiency with billing software, EMR systems, and clearinghouses.
  • Knowledge of EOBs, ERAs, denial codes, and appeal processes.
  • Strong analytical, organizational, and problem-solving skills.
  • Excellent communication and follow-up abilities.

Preferred Skills:

  • Experience with Home Health EMRs (e.g., Homecare Homebase, MatrixCare, Axxess, Alora, WellSky).
  • Familiarity with LUPA management and PDGM-specific adjustments.
  • Ability to manage high claim volume and maintain accuracy under

If this sounds like you, please complete this form: h t t p s

We will ONLY accept applications via the Google form above.

We will contact you within 3-5 days if you fit the requirements.

*Important Note*: Please make sure to check your spam or junk folders for the initial assessment invite. Sometimes, our emails may get filtered, and we wouldn't want you to miss this important step in the hiring process If you find our email there, be sure to move it to your inbox and mark it as "Not Spam" to ensure you receive all future emails from us directly in your inbox

Good luck

Job Type: Full-time

Pay: Php60, Php65,000.00 per month

Benefits:

  • Paid training
  • Work from home

Experience:

  • PDGM Claims: 1 year (Required)
  • Home Health: 1 year (Required)
  • Medical Account Receivable: 1 year (Required)
  • Medical Virtual Assistant: 1 year (Required)

Work Location: Remote

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