Personal Assistant Services Biller

About the Role

We are seeking a detail-oriented and experienced PAS (Personal Assistance Services) Biller to manage the end-to-end billing process for Personal Assistance Services, home health care, and community-based support programs.

This role ensures accurate and timely claim submission, payment posting, denial management, and reimbursement in compliance with Medicaid, Medicare (where applicable), Managed Care Organizations (MCOs), and other payer requirements.

You'll work closely with caregivers, schedulers, intake coordinators, authorization specialists, and the Revenue Cycle team to verify service documentation, maintain billing accuracy, resolve claim issues, and maximize reimbursement — all while ensuring regulatory compliance.

The ideal candidate has a strong understanding of Medicaid billing, Electronic Visit Verification (EVV), prior authorizations, and Home and Community-Based Services (HCBS) billing processes.

What You'll Do

PAS Billing Operations

• Prepare, review, and submit accurate claims for PAS and community-based care programs
• Verify patient demographics, insurance eligibility, payer information, and service authorizations before billing
• Ensure services billed match approved authorizations, care plans, and documented visits
• Validate EVV records prior to claim submission
• Submit claims electronically through payer portals and clearinghouses within required deadlines
• Maintain complete and accurate billing records per company policy

Claims & Revenue Cycle Management

• Monitor claims from submission through payment
• Investigate and resolve rejections, denials, underpayments, and payment delays
• Submit corrected claims and appeals as needed
• Coordinate with Accounts Receivable on outstanding balances and unpaid claims
• Reconcile payments and ensure accurate payment posting
• Identify reimbursement trends and recommend corrective actions

Authorization & Documentation Management

• Verify valid prior authorizations before claims are submitted
• Track authorization utilization and flag expiring authorizations
• Review caregiver documentation, visit notes, and service logs for billing accuracy
• Communicate documentation deficiencies to clinical/operations staff
• Ensure documentation supports all billed services per payer requirements

Compliance & Quality Assurance

• Ensure compliance with Medicaid, HIPAA, state regulations, and payer guidelines
• Stay current on billing regulation, fee schedule, and reimbursement policy changes
• Support internal and payer audits and documentation reviews
• Maintain confidentiality of patient and financial information

Reporting & Performance Monitoring

• Prepare daily, weekly, and monthly billing and reimbursement reports
• Monitor KPIs including clean claim rate, claims submitted, denial rate, Days in AR, collection rate, authorization utilization, and outstanding claims
• Report unresolved billing issues and trends to the Billing Manager

Collaboration

• Partner with Intake, Scheduling, Care Coordination, Clinical Services, Finance, and Accounts Receivable
• Participate in process improvement initiatives
• Support and guide team members on billing procedures and payer requirements

Requirements

Required

• High school diploma or equivalent; Associate's or Bachelor's degree in Healthcare Administration, Business Administration, or related field preferred
• Minimum 2 years of medical billing experience, preferably in PAS, Home Health, or HCBS
• Strong knowledge of Medicaid billing, MCOs, and payer guidelines
• Experience with Electronic Visit Verification (EVV) systems
• Proficiency in EMR systems, billing software, and Microsoft Office Suite
• Excellent analytical, organizational, and problem-solving skills
• Strong written and verbal communication skills
• Ability to manage multiple priorities while meeting billing deadlines

Preferred

• Certified Professional Biller (CPB) or other healthcare billing certification
• Experience with Texas Medicaid PAS billing and HCBS
• Knowledge of prior authorization management and denial appeals
• Familiarity with clearinghouses, payer portals, and revenue cycle management systems
• Experience supporting multi-site home care operations

Benefits

• Competitive executive salary
• Medical insurance
• Paid time off / holidays

Skills

Accounts Receivable, Analysis Skills, Billing, Billing Records, Billing Software, Business Administration, Clinical Medicine, Clinical Study Publications, Communication Skills, Community Support, Corporate Policies, Corrective Action, Detail Oriented, Documentation Review, Electronic Medical Records, Finance, HIPAA (Health Insurance Portability and Accountability Act), Health Plan, Healthcare Administration, High School Diploma, Home Care, Internal Audit, Maintain Compliance, Managed Care, Medicaid, Medical Billing, Medical Records, Medicare, Microsoft Office, Multitasking, Organizational Skills, Patient Administration Systems (PAS), Patient Care Authorizations, Patient Confidentiality, Payment Posting, Performance Analysis, Presentation/Verbal Skills, Problem Solving Skills, Process Improvement, Reconciliation, Reimbursement, Revenue Management, State Laws and Regulations, Time Management, Trend Analysis, Writing Skills

About the Company

PeopleOS