Billing Specialist

About the Organization Embark is a non-profit organization dedicated to helping each person we serve with meaningful employment as well as supporting the individual's growth and development. A recent merger with Twin Ports Guardianship and Payee Services has strengthened the organization's ability to support the financial well-being of our clients through different stages of life.

The MCO Billing Specialist is responsible for the accurate and timely billing, follow-up, and collection of claims submitted to managed care organizations. This role ensures compliance with payer-specific requirements, resolves claim denials and rejections, and supports the organization's revenue cycle by minimizing aging accounts receivable.

• Prepares, reviews, and submits clean claims to managed care payers via electronic and paper submission
• Verifies member eligibility, benefits, and authorization requirements prior to claim submission
• Researches, corrects, and resubmits denied, rejected, or underpaid claims within payer timely-filing limits
• Posts payments, adjustments, and denials
• Reconciles remittance advices (ERA/EOB) against expected reimbursement.
• Monitors accounts receivable aging and conducts proactive follow-up on outstanding claims
• Maintains current knowledge of payer contracts, fee schedules, and MCO-specific billing rules
• Communicates with payers, providers, and internal departments to resolve billing discrepancies
• Documents all account activity accurately in the billing/practice management system.
• Ensures compliance with HIPAA, payer guidelines, and applicable state and federal regulations
• Assists with month-end reporting and identifies trends in denials or reimbursement issues
• Consults with claim clerks at each MCO about any disputed claims and follows up on all bills not processed within the usual claim period.
• Prepares weekly and monthly reports of MCO billing

Attention to detail, analytical problem-solving, organization, and clear written/verbal communication.

Full-Time/Part-Time Part-Time

Pay Range $18-20/hour

EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status or any other characteristic protected by law.

This position is currently accepting applications.