Billing Specialist

FreedomCare is a healthcare company that has been dedicated to revolutionizing the home care industry since 2016. We support our patients by ensuring they have the power to choose a caregiver who will care for them in the comfort of their own homes. Our mission spans coast to coast, supporting patients across the U.S.

We pride ourselves on our values which drive the level of care that we deliver to our patients:

• Here For You (An attitude of service, empathy, and availability)
• Own It (Drive and ownership)
• Do the Right Thing (High integrity)
• Be Positive (Great attitude and a can-do positive approach to challenges)

Position Overview
The Finance/Billing team converts services delivered across FreedomCare programs into accurate, timely claims and supports follow-up through payment. The Billing Specialist prepares and submits claims, researches billing exceptions, and helps ensure that Electronic Visit Verification (EVV) data supports compliant billing and reimbursement.This is an individual contributor role requiring solid working proficiency, sound judgment, and the ability to independently resolve routine-to-moderately difficult billing and EVV issues with minimal supervision. The role is primarily focused on billing, with regular EVV monitoring, exception correction, submission support, and coordination across internal teams and external partners. Occasional travel may be required.

Responsibilities & Scope
•    Prepare and submit accurate claims or invoices to the appropriate payers, confirming eligibility, authorization, payer requirements, and required billing information before submission.
•    Review unpaid, delayed, rejected, or denied claims; determine the appropriate follow-up action; and prepare corrected, adjusted, or resubmitted claims when needed.
•    Monitor EVV reports, dashboards, and compliance results to identify missing visits, data mismatches, validation errors, failed transmissions, and other exceptions that may affect billing or payment.
•    Research and correct routine EVV visit exceptions in the appropriate source system, coordinate required updates, manage submissions and resubmissions, and verify that visit data is accepted and processed by the applicable aggregator or payer.
•    Reconcile EVV visit data to billing and claim information, including patient, caregiver, service, date, time, units, authorization, payer, provider, and program details, and resolve discrepancies before or after claim submission.
•    Work with payers, state agencies, EVV aggregators, HHAeXchange, Medflyt, Sandata, and internal operational teams to investigate issues, document findings, and support timely resolution; escalate policy, access, or technical-development issues appropriately.
•    Maintain clear, accurate, and audit-ready records of claim activity, EVV corrections, resubmissions, payer or vendor follow-up, adjustments, and issue resolution.
•    Run and review billing, eligibility, claims, and EVV reports to identify missing information, submission problems, unpaid claims, compliance gaps, or trends that may affect reimbursement.
•    Identify recurring billing or EVV issues, help determine root causes, and communicate trends and recommended process improvements to the Manager of Billing and cross-functional partners.

Collaboration and Escalation
The Billing Specialist works regularly with Billing, Operations, Payroll, Intake, Authorization, Compliance, Product/Technology, payer representatives, state EVV programs, and system vendors. The specialist owns routine billing and EVV issues through resolution and escalates matters involving unclear policy, system access, contractual interpretation, technical development, material compliance risk, or repeated failures that cannot be resolved through established workflows.
 
Education and Experience
•    High school diploma or equivalent required; associate or bachelor's degree in business, finance, healthcare administration, or a related field preferred.
•    Two or more years of healthcare billing, home care billing, Medicaid, managed care, revenue cycle, or payer operations experience preferred.
•    Experience with CDPAP, LHCSA, SFC, or multi-state home care billing environments is a plus.
•    Experience with EVV workflows, compliance monitoring, visit exception resolution, or EVV aggregators is preferred but not required.
•    Experience using HHAeXchange, Medflyt, Sandata, state EVV aggregators, or similar healthcare billing and operations systems is preferred.
•    Working knowledge of Excel, including the ability to filter, sort, format, reconcile, and review data for accuracy; intermediate Excel skills are preferred.

Qualifications
•    Working knowledge of billing workflows, claim submission, payer follow-up, denial and rejection research, and data accuracy expectations.
•    Strong attention to detail and the ability to identify discrepancies across claims, authorizations, billing records, and EVV visit data.
•    Ability to research errors, identify root causes, follow established procedures, and resolve routine-to-moderately difficult payer, system, or data issues independently.
•    Ability to manage a high-volume workload, meet deadlines, and shift priorities based on claim status, timely filing limits, EVV compliance, payer timelines, and operational needs.
•    Clear and professional communication skills for working with internal teams, payers, state agencies, EVV vendors, and billing system support partners.
•    Sound judgment regarding when to resolve an issue independently and when to escalate a complex, unusual, or high-risk matter.
•    Professional, patient, organized, and solutions-oriented approach to internal and external collaboration.

Measures of Success
•    Accurate and timely claim and invoice submission, with complete supporting billing information.
•    Timely identification and resolution of claim rejections, denials, unpaid claims, and EVV exceptions.
•    Improved EVV compliance and successful transmission, resubmission, and processing of required visit data.
•    Accurate, complete, and audit-ready documentation in billing and EVV systems.
•    Effective management of assigned work queues, aging items, follow-up commitments, and escalation timelines.
•    Clear communication of recurring issues, root causes, and operational trends that may affect reimbursement or compliance.

At FreedomCare, we celebrate diversity and are committed to creating an inclusive environment for all employees. We are an Equal Opportunity Employer and do not discriminate based upon race, religion, color, national origin, ancestry, age, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, status as a protected veteran, status as an individual with a disability, citizenship or immigration status, or other applicable legally protected characteristics.