Billing Specialist - CCSP

Job Description

Job Description

Billing Specialist

Who is Visiting Nurse Health System...

Serving the Atlanta Area for over 75 years, Visiting Nurse is a leading provider of home healthcare, long-term care at home, hospice, and palliative care services, helping patients and their loved ones receive care at home following an illness, surgery, or hospital stay.

Our vision is to be the first choice for patients, families, payers, and other healthcare providers when they need home healthcare services. To achieve patient and employee satisfaction scores and clinical outcomes within the top 10 percent of all home healthcare providers in the U.S. To continue to invest in our strong community partnerships, coordinated care solutions, top-performing workforce, and innovative technologies to improve affordability throughout the healthcare continuum. To be a financially strong organization where healthcare professionals prefer to work. For more information about Visiting Nurse, please visit vnhs.org.

For more information about our company, visit https://vnhs.org/

Summary

This role supports the CCSP program by creating and submitting accurate Service Authorizations in the electronic case management system and forwarding them to the State Medicaid Billing system (GAMMIS). It serves as a liaison between case managers and service providers, helping resolve billing issues. The position requires knowledge of Medicaid Waiver billing rules, prior authorizations, ICD-10 codes, and GAMMIS. It also involves preparing and updating billing-related departmental reports in a timely manner.

Key Responsibilities

Communications

• Maintain strong relationships with leadership and program contacts.
• Inform Operations Managers of outstanding documentation issues.
• Serve as a resource for staff on policies, billing standards, and compliance.
• Support performance improvement and financial initiatives.

Administrative

• Create and update departmental reports accurately and promptly.
• Apply performance improvement principles in daily tasks.

Billing

• Demonstrate expertise in Medicaid regulations and GAMMIS.
• Submit service authorizations and Medicaid claims (electronic/paper).
• Resolve billing issues between case management and service providers.
• Educate staff on billing procedures.
• Review and verify billing batches and claim submissions.

Regulatory

• Stay current with billing regulations and insurance guidelines.
• Ensure compliance with federal, state, and local standards.

Organization

• Maintain a clean and organized workspace.
• Keep a reference guide for continuity during absences.

Company Values

• Respect and Integrity
• Excellence
• Stewardship
• Care

Minimum Qualifications

Associate’s degree required, bachelor's or higher preferred

Minimum of two (2) years of experience in a Healthcare related field

Strong data entry skills

Strong attention to detail, excellent communication and interpersonal skills.

Proficient in using computers and various software applications (Excel specifically).

Self-motivated and able to work independently in a remote setting.

Previous experience working in skilled nursing, assisted living, or long-term care settings.

Highlights:

Day shift hours, Monday-Friday

Preferred Qualifications:

Familiarity with Medicaid Waiver prior authorization

Experience with ICD-10 Codes & GAMMIS

Visiting Nurse Health System (VNHS) is dedicated to the principles of Equal Employment Opportunity. We affirm, in policy and practice, our commitment to diversity. We do not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable or state law, genetic information, or any other characteristic protected by applicable federal, state and local laws and ordinances.

The EEO policy applies to all personnel matters as outlined in our company policy including recruitment, hiring, transfers, and general treatment during employment.

The company is unable to provide sponsorship for a visa at this time (H1B or otherwise).