Medicaid Billing Specialist – Home Care

BG healthcare Service

Medicaid Billing Specialist – Home Care

Falls Church, VA
Full Time
Paid
  • Responsibilities

    Benefits:

    401(k)

    Dental insurance

    Health insurance

    Paid time off

    Full-Time | On-site

    BG Healthcare Services is seeking a detail-oriented, proactive Medicaid Billing Specialist to join our home care operations team. This role is ideal for someone with hands-on experience billing Virginia Medicaid and MCOs, who is passionate about accuracy, compliance, and driving revenue integrity for a growing healthcare organization.

    What You'll Do:

    · Submit claims to Virginia Medicaid and all contracted MCOs (e.g., Aetna, UHC, Anthem, Sentara) for Personal Care Services

    · Monitor claim status and resolve denials through timely resubmissions and payer communication

    · Track authorizations, units used, and billing limits to avoid under/overutilization

    · Manage WAMS and EVV compliance for claims readiness

    · Maintain caregiver documentation logs to support billing audits

    · Communicate regularly with support coordinators and payer reps to ensure timely reimbursement

    · Collaborate with intake and scheduling teams to ensure authorizations and visits are aligned

    What We're Looking For:

    · 1 - 2+ years of experience in Medicaid billing (preferably in home care, personal care, or home health)

    · Strong knowledge of Virginia Medicaid, including MCO claim portals and WAMS

    · Experience with EVV systems (HHAeXchange, myEVV, Sandata, etc.)

    · Understanding of common denial codes and billing corrections

    · Excellent attention to detail and documentation practices

    · Comfort working in a small, collaborative office with shared responsibilities

    Nice to Have:

    · Familiarity with caregiver compliance audits or HR onboarding processes

    · Experience supporting intake, plan of care tracking, or Medicaid documentation audits

    Compensation & Benefits:

    · Competitive hourly rate (commensurate with experience)

    · PTO, paid holidays, and health insurance options

    · Supportive leadership and opportunity to grow as the agency scales

    If you’re a Medicaid billing professional who wants to be more than just a cog in the machine — and you're ready to help shape the financial foundation of a mission-driven home care agency — we want to hear from you.