Accounts Receivable Specialist [100% WFH graveyard]

Taio Connect; Metro Manila; Remote; PHP 250,000 - 400,000; Full time

Job summary

Taio Connect in Metro Manila is seeking an Accounts Receivable Specialist to manage home health billing, insurance follow-up, and collections to ensure timely reimbursement from Medicare, Medicaid, and commercial payers.

You will post payments, resolve denials, monitor aging, and collaborate with clinical and billing teams to ensure PDGM/CMS compliance and accurate reimbursements.

Qualifications

• 2+ years AR experience in Home Health or Healthcare.
• Strong knowledge of Medicare home health billing and reimbursement.
• Experience with Medicaid and commercial payers.
• Familiarity with EOBs, ERAs, CPT/HCPCS, ICD-10.
• Proficient with EMR/EHR and billing systems.

Responsibilities

• Monitor, analyze, and follow up on outstanding AR balances for home health claims.
• Post insurance and patient payments; reconcile accounts.
• Resolve denials and manage 30/60/90+ day aging.
• Identify root causes of denials and submit corrections and appeals.
• Ensure compliance with CMS and PDGM guidelines; collaborate with teams.

Skills

Accounts Receivable

Healthcare Billing

Denial Management

Analytical Thinking

Communication

Education

High school diploma or equivalent

Associate’s degree preferred

Tools

EMR/EHR systems

Homecare Homebase / WellSky

Job description

Overview

The Accounts Receivable (AR) Specialist is responsible for managing and resolving outstanding accounts

receivable for a home health agency. This role focuses on insurance follow-up, payment posting, denial

management, and collections to ensure timely and accurate reimbursement from Medicare, Medicaid,

commercial payers, and patients. The ideal candidate has strong knowledge of home health billing

regulations and US healthcare reimbursement processes.

Responsibilities and Duties

Accounts Receivable & Collections

• Monitor, analyze, and follow up on outstanding AR balances for home health claims
• Perform payer follow-up via portals, phone calls, and written correspondence
• Resolve unpaid, underpaid, or denied claims in a timely manner
• Work aging reports (30/60/90+ days) to reduce days in AR

Insurance & Billing Follow-Up

• Review Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERA)
• Identify root causes of denials and initiate corrective actions
• Submit corrected claims, appeals, and supporting documentation
• Ensure compliance with Medicare home health billing guidelines, including PDGM
• Monitor, analyze, and resolve LUPA (Low Utilization Payment Adjustment) claims by reviewing visit utilization, identifying variances from the episode threshold, and collaborating with clinical and billing teams to ensure accurate reimbursement and appropriate adjustments when applicable.

Payment Posting & Reconciliation

• Post insurance and patient payments accurately
• Reconcile accounts and identify payment discrepancies
• Process adjustments, refunds, and write-offs per company policy

Documentation & Compliance

• Maintain accurate notes and documentation in the billing system
• Ensure compliance with CMS, Medicare, Medicaid, and commercial payer regulations
• Collaborate with intake, coding, and clinical teams to resolve billing issues

Reporting & Communication

• Prepare AR status reports and collection summaries
• Communicate trends, denial issues, and payer concerns to leadership
• Respond to patient and payer inquiries regarding balances and payments

Requirements

Required Qualifications

• High school diploma or equivalent (Associate’s degree preferred)
• 2+ years of Accounts Receivable experience in Home Health or Healthcare
• Strong knowledge of Medicare home health billing and reimbursement
• Experience working with Medicaid and commercial insurance payers
• Familiarity with EOBs, ERAs, CPT/HCPCS codes, and ICD-10
• Proficiency with EMR/EHR and billing systems (e.g., Homecare Homebase, WellSky, or similar)
• Strong analytical, organizational, and problem-solving skills

Preferred Qualifications

• Home Health AR or Billing Certification (AAPC or AHIMA preferred)
• Experience with PDGM and Notices of Admission (NOA)
• Experience in appeals and denial management
• Advanced Excel or reporting skills

Key Skills & Competencies

• Revenue Cycle Management
• Insurance Follow-Up & Collections
• Denial Resolution
• Attention to Detail
• Time Management
• Communication & Collaboration