Job description

This position will oversee daily operations to ensure that all service documentation complies with funding source requirements in order to submit billing claims for a variety of rehab programs. Works in conjunction with a team of Billing Specialists under supervision of a Program Manager or Director. Duties:

  • Obtaining and reviewing documents from outside agencies required for service authorization
  • Monitoring the eligibility of clients to attend programs
  • Maintaining folders and documents in audit-ready condition
  • Verifying units of service/billing for programs as determined by model (daily/hourly/milestone etc.)
  • Reviewing service notes and documentation for accuracy and required elements
  • Tracking clients’ eligibility for services; following-up with funders and insurance companies to resolve issues
  • Running billing and attendance reports in EHR (Electronic Health Records)
  • Submitting billings in web-based applications; tracking remittance reports and following-up on denied claims
  • Submitting applications for service approval in required format
  • Obtaining documents required for service authorization and billing, scanning into EHR, and tracking expiration dates in database
  • Reviewing Service Plans for required billing elements; implement as needed
  • Tracking Service Plans, meetings, and monthly events and liasing with program staff and supervisors
  • Reviewing received documents for requirements, requesting changes as needed
  • Reviewing EHR to determine compliance with requirements
  • Entering data for new starts into EHR; creating paper records as needed
  • Delivering staff training in EHR and funding source requirements as needed
  • Filing documents and other duties as requested by supervisor

What you need to have

  • Working knowledge of MS Word, Excel and Outlook, and the Internet is required
  • Detail-oriented, well-organized and very consistently accurate
  • Able to work with a team in a fast-paced environment
Prior experience & qualifications
  • Able to develop a strong working knowledge of funding sources, federal and state regulations to assist programs in maintaining compliance
  • BA or BS in a relevant area is preferred
  • Prior experience with managed care, Medicaid, or other private insurance funding, or some kind of service billing experience
  • Prior experience with people with disabilities
  • Prior experience in billing, bookkeeping, compliance or related field strongly preferred
  • Travel to various program may be required
This opportunity requires fluency in English