Medicaid Billing Specialist

About the Role

As a Medicaid Billing Specialist at Pathfinder, you play a vital behind-the-scenes role that ensures critical services are funded accurately and on time. Your work directly supports our residential and waiver programs, helping Pathfinder continue to provide high-quality, person-centered services to the individuals we serve.

• Manage all aspects of Medicaid billing for Group Homes and Waiver Homes
• Ensure services are billed accurately and in alignment with Notices of Action (NOAs)
• Analyze Medicaid billing revenue to confirm all allowable services are captured

• Partner closely with Program Directors and internal teams to ensure proper billing procedures
• Serve as a billing resource across departments to resolve questions and discrepancies
• Provide backup support to the Accounts Receivable Grants Specialist as needed

• Research, resolve, and follow up on disputed or denied Medicaid claims
• Review Medicaid receivables regularly and address past-due balances
• Maintain accurate billing documentation and records

• Prepare monthly Medicaid billing, adjustment, and revenue reports
• Assist with the monthly close process
• Support year-end financial audits, Medicaid audits and other reviews

• Update supported living lease agreements annually
• Stay current on Medicaid billing regulations and reimbursement procedures
• Participate in continuing education and required trainings

• Help ensure Pathfinder receives the funding needed to support individuals and programs
• Strengthen financial accuracy and compliance across residential services
• Support program teams by reducing billing errors and delays
• Contribute to Pathfinder’s mission by ensuring services are properly documented and reimbursed

Pathfinder’s mission is to strengthen communities by enabling people with disabilities or economic challenges to achieve autonomy, inclusion, and stability.

• Competitive Pay & Paid Training – Earn while you learn with comprehensive training.
• Paid Time Off & Holidays – Maintain a healthy work-life balance with PTO and paid holidays.
• Comprehensive Insurance Coverage – Medical, Dental, and Vision plans to support your well-being.
• Employer-Paid Coverage – Enjoy free Basic Life Insurance, Short-Term Disability (STD), and Long-Term Disability (LTD).
• 403(b) Retirement Plan with Employer Match – Plan for your future with a generous retirement savings plan and employer contributions.
• Tuition Reimbursement – Invest in your future with financial assistance for continued education.
• Professional Development & Training – Enhance your skills and career through learning opportunities.
• Person-Centered Thinking Training – Gain valuable insights into individualized care and service.

• Wellness Platform Incentives – Earn rewards for prioritizing your health and well-being.
• Financial Wellness Platform – Access earned wages before payday for added financial flexibility.
• Employee Assistance Program (EAP) – Free, confidential support sessions for employees and their immediate household members.
• Free Pathfinder Kids Clinic – Providing childcare for children in the community with minor illnesses.
• Exclusive Discounts – Save with special offers, including:
• Verizon Wireless Discount – Stay connected for less.
• YMCA Discount – Enjoy reduced membership rates for fitness and wellness.

People First – Integrity - Contribution – Growth – Empowerment

• Minimum of high school diploma/GED; associate or bachelor’s degree preferred.
• A minimum of one year experience in accounting preferred.
• Ability to develop and deliver accurate data for review or presentation.
• Proficiency in Microsoft Office products and accounting software.
• Excellent written and verbal communication.
• Ability to speak, hear, and read the English language.