Note: The job is a remote job and is open to candidates in USA. Cornerstone Caregiving is a nationwide home care company committed to helping seniors receive high-quality care in a healthy and dignified environment. The Medicare Programs Billing Specialist manages PACE billing and provides financial oversight of GUIDE billing activities, ensuring accuracy, timeliness, compliance, and reconciliation. The role also researches discrepancies, monitors claims and receivables, and supports consistent billing controls and processes.
Responsibilities
- Own and manage the complete PACE billing process
- Prepare, review, and submit PACE claims and billing on a timely basis
- Ensure all billable services are supported by appropriate documentation and meet applicable billing requirements
- Monitor PACE billing for accuracy, completeness, and compliance
- Track submitted claims, payments, denials, rejections, adjustments, and outstanding balances
- Research and resolve billing discrepancies and rejected or denied claims
- Reconcile PACE billing activity to payments and financial records
- Maintain accurate billing records and supporting documentation
- Provide financial oversight of GUIDE billing activities performed by designated billing staff
- Monitor GUIDE billing to ensure claims and invoices are submitted timely and accurately
- Review billing reports and financial activity for unusual trends, discrepancies, or missing information
- Monitor outstanding GUIDE claims and receivables
- Assist billing staff with escalated billing questions or issues
- Ensure GUIDE billing activity is properly reconciled and reflected in Finance records
- Communicate recurring billing issues or concerns to Finance leadership and appropriate operational staff
- Help establish and maintain consistent billing controls and processes
Skills
- High school diploma or equivalent required
- 2+ years of experience in medical, healthcare, human services, or other third-party billing
- Experience with accounts receivable, claims processing, payment posting, and reconciliation
- Strong attention to detail and ability to identify discrepancies
- Strong organizational skills and ability to manage multiple locations and competing deadlines
- Proficiency with Microsoft Excel and other Microsoft Office applications
- Ability to work independently while collaborating effectively with operational and Finance teams
- Ability to maintain confidentiality and handle sensitive financial and participant information
- Associate or bachelor's degree in accounting, finance, business, or related field preferred
Benefits
- Unlimited PTO
- Medical, Dental & Vision coverage
Company Overview