BILLING & FINANCE COORDINATOR

Location: Providence, RI
Type: Full-Time | 35-40 Hours Per Week | W-2 or 1099
Starting Pay: $25/hour

ABOUT GOOD SHEPHERD HOME CARE LLC

Good Shepherd Home Care is a culturally sensitive, non-medical home care agency proudly serving Rhode Island. We believe every client deserves dignified care, and every caregiver deserves trustworthy support. Now, we’re looking for a proactive Billing Specialist who’s committed to accuracy, accountability, and Medicaid compliance.

POSITION SUMMARY

We’re seeking a Billing Specialist with experience in Medicaid billing for non-skilled home care. You’ll be responsible for claim preparation, submission, and correction using HHAeXchange, Inovalon, and QuickBooks. Your role is crucial in ensuring accurate billing, regular audits, and account transparency across payers. The ideal candidate is detail-oriented, tech-savvy, and solutions-driven.

QUALIFICATIONS

• 2+ years of experience in Medicaid billing or home care claims
• Strong understanding of CMS-1500, EVV, modifiers, and service codes
• Proficiency with HHAeXchange and Inovalon (required)
• Experience with QuickBooks and general AR/AP tracking
• Organized, self-motivated, and capable of conducting internal audits
• Excellent written and verbal communication (Bilingual Spanish/English preferred)
• Knowledge of MCO payers (Tufts, NHPRI, UHC, etc.) a plus

PREFERRED SOFT SKILLS

• Strong initiative and commitment to improving processes
• Analytical mindset with comfort reviewing data sets
• Accountability – Own your work, follow up without being asked
• Collaborative – Able to work cross-functionally and ask the right questions

BONUS EXPERIENCE

• Familiarity with EVV compliance rules for RI Medicaid
• Knowledge of denial management, appeals, and state-level billing audits
• Ability to build out SOPs and contribute to billing workflows
  Job Type: Full-time
  Pay: From $25.00 per hour
  Expected hours: 35 – 40 per week

Benefits:

• 401(k)
• Dental insurance
• Life insurance
• Paid time off

Work Location: In perso

Claims & Billing Execution

• Submit, track, and correct CMS-1500 claims and other forms as required
• Ensure visit data is clean, verified, and EVV-compliant
• Manage and reconcile billing batches in HHAeXchange and Inovalon
• Resubmit rejected/denied claims and maintain accurate logs

Remits & Accounts Oversight

• Track remittance advice (RA/EOBs) and report unprocessed or underpaid claims
• Maintain accounts receivable tracking sheet with weekly summaries
• Generate internal billing reports for agency leadership

Compliance & Communication

• Follow up on pending claims via payer portals or phone
• Open and manage support tickets with clearinghouses (Inovalon) or EMRs
• Coordinate closely with Payroll, Scheduling department
• Assist with Medicaid EVV compliance and ensure timely visit verification

Reporting & Financial Oversight

• Maintain internal billing dashboards for weekly and monthly trends
• Track financial performance of key billing categories (e.g., modifiers, pass-through services)
• Create summaries for executive review on billed vs. paid vs. outstanding
• Support Medicaid audits or RIDOH surveys with required billing documentation
• Coordinate with Director of Operations for financial planning and forecasting inputs
• Reconcile QuickBooks data with actual remits and cash flow trends (light accounting)