Position: Home Health Medical Billing & Coding Specialist

Job Type: Full-time (40 hours/week)

Location:Philippines (Remote, EST hours)

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Overview

We are seeking a highly organized and experienced Home Health Medical Billing & Coding Specialist to support home health coding, Plan of Care generation, quality assurance, documentation review, and revenue cycle workflows.

This role requires strong U.S. home health experience, hands-on proficiency with WellSky/Kinnser, knowledge of Medicare and CMS requirements, and the ability to accurately review clinical documentation and OASIS assessments for coding and billing readiness.

The ideal candidate is proactive, detail-oriented, highly responsive, and capable of independently managing home health coding and QA workflows while ensuring Plans of Care and clinical documentation are accurate, compliant, and ready for billing.

Key Responsibilities****Home Health Coding & Plan of Care Generation

• Reviewed OASIS assessments, physician orders, referrals, and clinical documentation to determine and support accurate home health diagnosis coding.
• Assigned, sequenced, and validated ICD-10-CM codes in compliance with home health guidelines, ensuring alignment with OASIS data, clinical records, and PDGM/CMS requirements.
• Developed and reviewed Plans of Care (POC) based on patient conditions, diagnoses, medications, and prescribed services, ensuring accuracy and consistency with documented care.
• Identified and resolved coding discrepancies and unclear diagnoses, maintained current regulatory knowledge, and utilized WellSky/Kinnser to manage coding and documentation workflows.

Quality Assurance & Documentation Review

• Conducted comprehensive QA reviews of patient charts, OASIS assessments, and clinical documentation to ensure accuracy, consistency, and compliance with Medicare and agency standards.
• Performed pre-billing audits to validate completeness of visit notes, Plans of Care, physician orders, and certifications, ensuring records were claim-ready.
• Identified and resolved documentation gaps, coding discrepancies, missing signatures, and compliance risks through collaboration with clinical staff.
• Supported audits, recertifications, and survey readiness by maintaining documentation integrity and ensuring timely completion of all required records.

Clinical & Operational Coordination Support

• Coordinated with nurses, therapists, physicians, intake staff, and leadership to address coding and documentation requirements across home health workflows.
• Tracked and followed up on pending documentation, physician orders, signatures, and deficiencies to ensure timely completion and compliance.
• Maintained organized oversight of coding inquiries, Plans of Care, claims, authorizations, and workflow status to support operational efficiency.
• Identified workflow bottlenecks and collaborated with clinical and operational teams to improve documentation accuracy, billing readiness, and overall process efficiency.

Compliance & Regulatory Responsibilities

• Ensured compliance with CMS regulations, Medicare Conditions of Participation (CoPs), HIPAA standards, and home health requirements.
• Maintained strong knowledge of Medicare home health coding, billing, and reimbursement guidelines to support accurate and compliant practices.
• Verified alignment of OASIS documentation, diagnosis coding, and Plans of Care with supporting clinical records.
• Supported audit readiness and risk reduction by minimizing coding errors, denials, and compliance issues while maintaining accurate documentation in WellSky/Kinnser.

Preferred Skills & Qualifications

• Minimum 3+ years of experience in U.S. home health billing, coding, QA, or revenue cycle, with direct support of Medicare-certified home health agencies.
• Strong expertise in ICD-10-CM coding, OASIS documentation, and Plan of Care (POC) development within home health settings.
• In-depth knowledge of Medicare home health workflows, including PDGM, NOA processes, physician orders, and documentation requirements.
• Proven experience performing clinical documentation QA and pre-billing reviews, identifying discrepancies and ensuring compliance.
• Proficient in WellSky/Kinnser with the ability to manage coding, documentation, and workflow processes efficiently.
• Excellent analytical, organizational, and communication skills, with the ability to work independently in fast-paced remote environments while collaborating effectively with clinical and leadership teams.

Nice-to-Have (Bonus Skills)

• Relevant certifications such as HCS-D, CCS, CPC, CCA, or CPB (or equivalent home health coding/billing credentials).
• Experience managing both coding and QA workflows within Medicare-certified home health agencies.
• Advanced expertise in complex diagnosis coding, including multiple comorbidities, and denial management, appeals, and reimbursement recovery.
• Proven ability to support audits and surveys while improving documentation quality, coding accuracy, clean-claim rates, and overall operational efficiency.

What we offer:

• Fixed U.S. working schedule
• Fully remote role — work from anywhere
• Direct collaboration with U.S. small businesses and entrepreneurs
• Paid time off — 10 PTO days per year, plus 6 U.S. holidays off