Billing Specialist II

The Billing Specialist II manages the billing process for a range of agency programs, including the accurate and timely submission of Medicaid claims, reconciliation of attendance and billing records, research and resolution of claim denials and billing exceptions, reconciliation of cash receipts, and maintenance of Fiscal Department records. The position works within established billing procedures and regulatory requirements and coordinates regularly with program staff, the Banking Team, and other internal departments to maintain billing accuracy and compliance.

Essential Functions and Primary Responsibilities of Position:

• Reviews attendance records and submits weekly or monthly Medicaid billing for assigned programs, including:
  • Day Habilitation (Day Hab)
  • Supervised Individualized Residential Alternatives (IRA)
  • Community Living Program (CLP)
  • Children's Residential Program (CRP)
  • Respite
  • Community Habilitation (Comm Hab)
• Reconciles attendance reports against billing reports to identify billing discrepancies and resolves variances as needed.
• Collaborates with program staff to research and resolve denied claims, pending claims, unbillable units, and billing exceptions.
• Reconciles cash receipts with the Banking Team and verifies the accurate recording of payments.
• Retrieves weekly Medicaid payment information and verifies receipt of funds.
• Reviews and prepares check and cash deposits received by the Billing department.
• Prepares invoices for private payors, ensuring timely and accurate billing.
• Verifies semi-annual clothing allowance rosters for accuracy and supports reimbursement processing.
• Maintains and monitors Fiscal Department records in accordance with the organization's record retention policy.
• Maintains the confidentiality and security of protected health information and financial records in accordance with HIPAA, Medicaid, and agency policies.
• Performs other job-related duties as assigned, consistent with the scope, responsibilities, and level of the position, and in compliance with applicable laws, regulations, and organizational policies.

Work Environment and Schedule

The work environment described here is representative of the physical environment, working conditions, and schedule associated with this position.

• Standard 35-hour work week, Monday through Friday.
• Hybrid schedule following the 90-day introductory period: alternating weeks of two days in office with three days remote, and three days in office with two days remote.
• Professional office environment with a balance of independent work and cross-functional collaboration.
• Regular coordination with program staff, the Banking Team, and other Fiscal Department personnel.
• Periods of increased volume around billing cycles and reporting deadlines.