Job description

Exciting opportunity for a qualified candidate with a sense of humor who can work well with others, who is also self-motivated, detail-oriented, flexible and able to respond to frequently shifting work priorities. As a Billing Specialist in the Compliance Division, some responsibilities will include (but not limited to):

  • Strong focus on the accuracy of billing for Medicaid funded programs. Will work to minimize billing errors and ensure compliance with applicable laws and regulations.
  • Development of comprehensive billing assessment summaries and reports after audit concludes; billing audits using AccuMed and Foothold software and other tools to verify validity of submitted claims. Detailed reports of work performed will include findings, conclusions and recommendations
  • Outstanding attention to detail and excellent time management skills. This position requires mastery of a large amount of detail.
  • Detailed reporting of the work performed findings, conclusions, and recommendations. Will conduct focused meetings with program staff to develop reports and provide guidance on billing documentation.
  • Monitoring and researching changes to applicable federal, state and local laws, contractual and governmental regulations affecting the agency’s billing, programs, and operations.
  • Continuously updating knowledge and proficiency of programs to assure accurate review of Medicaid documentation and billing.
  • Developing checklists that directly correlate with the program’s documentation and billing requirements.
  • Communicating with program staff/management through positive attitude, respectful interaction, efficiency, and ethical behavior.
  • Generating complete and accurate reports within a specific time frame.
  • Adherence to auditing policies and procedures in all assigned areas of responsibility assigned by the Compliance Division.
  • Ability to ensure accurate and meaningful reporting and analysis billing.
  • Collecting and entering billing data into spreadsheets in order to determine validity of payment.
  • Reviewing, analyzing, identifying any inaccuracy, and report on all billing related matters to Medicaid funded programs.
  • Appropriately and professionally respond to sensitive inquiries or complaints.

What you need to have

  • Ability to read, analyze, and interpret general business periodicals, financial reports, legal documents or governmental regulations and other technical information.
  • Ability to write reports, business correspondence, and procedures.
  • Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals and compute rate, ratio, and percentages.
  • Ability to identify and define problems, collect data, and establish facts and as well as defend valid conclusions.
  • Ability to deal with several abstract and concrete variables, exercising judgment, resourcefulness, ingenuity and initiative in a professional way.
  • Strong proficiency in Word, Excel, PowerPoint, AccuMed, Foothold, and other analytical software.
  • Able to work both in a team and independently with limited assistance and supervision.
  • Communicate effectively with program staff and management through positive attitude, respectful interaction, efficiency, and ethical behavior.
  • Prioritize and meet deadlines.
  • Exercise discretion while regularly handling confidential information.
  • Special working condition: Must have sense of humor and work well with others!
Prior experience & qualifications

Bachelor's degree (B. A.) from four-year college or university preferred and/or 5 years' experience in contract compliance; or the equivalent combination of education and experience.

  • Highly competent in operating office equipment.
  • Requires mastery of a large amount of attention to detail and excellent time management skills.
  • Able to travel when necessary.
This opportunity requires fluency in English