Billing Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Submit invoices to payers, monitor payments, handle denials, verify the accuracy of payments, apply payments, and resolve disputes related to payments.

• Track unpaid invoices, investigate rejections and denials, rectify billing errors, and file appeals with payers.

• Act as the main point of contact for payers concerning any payment discrepancies.

• Manage DSO payment timelines, ensuring that no receivables exceed 90 days.

• Submit invoices via direct payer channels, payer portals, clearinghouses, and other necessary methods.

• Attach and verify compliance of supporting documentation, which includes bids, completed assessments, proof of work completion, photographs, and client sign-off forms.

• Apply the correct billing codes, HCPCS modifiers, and unit caps for EAA and home modification waiver programs.

• Reconcile payments with invoices or claims and record payments in internal billing software.

• Document and implement billing requirements for both existing and new payer business.

• Oversee invoices and payments to network providers.

⛳️ Requirements

• A minimum of 3 years of experience in ancillary medical billing and collections, preferably in non-medical billing and collections, particularly with MCOs and various payer types.

• Proven history of successfully managing billing and collections for ancillary or non-medical benefits.

• Strong understanding of Medicaid, Medicare, and dual-eligible billing guidelines and compliance standards.

• Direct experience with ILOS, HCBS, and LTSS waiver codes.

• Proficient in using payer portals, clearinghouses, EDI systems, and billing/EHR platforms.

• Exceptional attention to detail regarding billing requirements, coding, modifier usage, authorization unit counts, and documentation attachments.

• Excellent verbal and written communication skills for engaging with internal teams, case managers, and payer representatives.

• Direct billing experience for ancillary and community-based services is preferred.

• Specialized knowledge of state waiver billing rules is preferred.

• Familiarity with billing regulations and compliance regarding government programs.

• Ability to collaborate across the organization to complete necessary job tasks.

🏝️ Benefits

• Offers Equity

• Full benefits

• Remote work arrangement