Billing Specialist and Administrative Assistant

Summary

The Billing Specialist and Administrative Assistant for the Adult Day Center, including Medicaid, Department of Mental Health (DMH), Veterans Affairs (VA), and private pay accounts. This position prepares and submits accurate billing, monitors payments and outstanding balances, resolves billing discrepancies, and maintains complete financial and participant records.

The specialist works closely with the Accounting Department, program director, staff, participants, families, and funding agencies to support timely reimbursement and responsive customer service. The position also provides administrative support to the program as needed.

Responsibilities

Billing Responsibilities

• Prepare, review, and submit accurate and timely claims and invoices to Medicaid, DMH, VA, and private pay accounts in accordance with payer requirements and Accounting Department procedures.
• Coordinate billing for other program funding sources and services, as applicable, including insurance, CACFP, MEAAA, scholarships, and rentals.
• Verify participant billing information, payer eligibility, service authorizations, approved attendance schedules, and applicable rates before submitting billing.
• Reconcile participant attendance and service records with claims and invoices to ensure services are billed accurately.
• Monitor authorization dates and service limits; coordinate with program staff and funding agencies to address missing or expiring authorizations.
• Track submitted claims, payments, adjustments, denials, and outstanding balances. Coordinate payment posting and account reconciliation with the Accounting Department.
• Research and resolve rejected or denied claims, underpayments, and other billing discrepancies. Submit corrections and supporting documentation as needed.
• Review accounts receivable aging reports and follow up on unpaid claims and overdue accounts.
• Manage private pay accounts, including account setup, invoices, statements, payment tracking, billing inquiries, and past-due follow-up.
• Coordinate payment arrangements and account adjustments with authorized staff in accordance with organizational policies.
• Prepare deposits and supporting documentation following Accounting Department procedures.
• Prepare monthly billing, collections, and outstanding balance reports for the program director and Accounting Department.
• Maintain organized billing records and supporting documentation for reconciliations, audits, and funder reviews.
• Protect confidential participant and financial information in accordance with organizational policies and applicable requirements.

Participant Records and Attendance

• Create and maintain accurate paper and electronic participant files, ensuring required enrollment and billing documentation is complete.
• Update participant account information following changes in enrollment, payer source, service authorization, or discharge.
• Track and reconcile daily attendance in accordance with program and funder requirements.
• Work with the Transportation Coordinator and program staff to verify attendance, absences, and make-up days for billing purposes.
• Record admissions and discharges, prepare required monthly reports, and complete final billing and record processing upon discharge.
• Maintain attendance reports in participant files according to organizational retention procedures.

Customer Service and Administrative Support

• Serve as the primary contact for participant and family billing questions, explaining charges, payments, and account balances clearly and professionally.
• Communicate with funding agencies, participants, families, and staff to resolve account questions and obtain missing documentation.
• Answer incoming calls, respond to messages, greet visitors, and direct inquiries to appropriate staff.
• Prepare billing correspondence and other program communications as needed.
• Assist with purchase orders, office supply orders, receipts, and expense reports in accordance with organizational procedures.
• Provide administrative support to the program director and staff, including distributing mail and assisting with program reports.
• Perform other duties as assigned.