Job Summary
We are seeking a detail-oriented and proactive Billing and Compliance Assistant to join our dynamic team. In this role, you will be responsible for supplementing and auditing our billing and quality assurance processes. This position offers an exciting opportunity to contribute to a thriving organization dedicated to excellence in financial operations as well as our dedication to compliance and quality.

Responsibilities

• Prepare and submit claim billing.
• Review service documentation for accuracy and completeness.
• Verify and obtain approval letters to create and maintain authorizations, service units, and billing information.
• Track denied claims and assist with claim corrections and resubmissions.
• Maintain billing reports, spreadsheets, and other reports.
• Verify insurance eligibility to ensure ongoing eligibility status.
• Review documentation for compliance with Medicaid, state, and agency requirements.
• Monitor documentation timelines and report missing or overdue paperwork.
• Support internal quality assurance and compliance reviews.
• Maintain organized compliance and billing records.
• Track staff trainings, credentials, and required documentation.
• Ensure confidentiality and HIPAA compliance standards.
• Support MCO audit preparation and documentation collection.
• Conduct QA calls to parents/legal guardians following an annual QA call schedule.
• Gather data for reports and field billing/documentation inquires.

Requirements

• Must obtain a high school diploma or GED - College courses preferred.
• Must have 2 years of administrative experience. - Experience in healthcare, behavioral health, I/DD services, or Medicaid billing preferred.
• Basic understanding of Medicaid documentation and compliance standards - Preferred experience in conducting participant chart reviews or other relevant quality assurance work.
• Strong organizational and multitasking skills.
• Attention to detail and accuracy.
• Disciplined to have access to sensitive personal information and maintain the highest standards of confidentiality.

Pay: $15.00 - $17.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Application Question(s):

• On a scale of "Little", "Average", and "Strong", please rate your familiarity with basic understanding of Medicaid documentation, and compliance standards. Please also briefly explain why you rated yourself that way.

Education:

• High school or equivalent (Required)

Experience:

• Administrative: 2 years (Required)

Work Location: In person