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.

High school diploma or GED required; associate's degree in accounting, finance, or a related field preferred.

Two to five years of experience as a Billing Clerk, Billing Specialist, or in a comparable financial role.

Working knowledge of billing and accounting principles.

Proficiency with the Microsoft Office Suite, particularly Excel and SharePoint.

Working knowledge of billing and Medicaid systems, or the demonstrated ability to learn them, including:o Millin Proo Precision Careo eMedNYo CHOICES Strong organizational skills and a high level of attention to detail.

Effective written and verbal communication and interpersonal skills.

Ability to handle sensitive and confidential information appropriately.

Ability to work independently and as a contributing member of a team.

Physical Demands and Travel Requirements The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Constantly required to exchange accurate information in person, by telephone, and in writing

Constantly operates a computer, billing systems, and other standard office equipment

Frequently required to remain in a stationary seated position for extended periods

Occasionally moves about inside an office to access files, equipment, and colleagues

Occasionally lifts or moves office materials weighing up to 10 pounds

Occasionally travels to other agency sites as business needs require

Benefits

At Heart Share we offer a comprehensive benefit package based on full-time/part-time status. You can expect:

Rewarding Work in a team environment.

Paid vacation, sick, personal days, and…