Billing Specialist

About This Role

Putting billing expertise to work for a meaningful mission, this role secures reimbursements, resolves claims, and supports a nonprofit that helps families stay close to their hospitalized children. The specialist will own the billing process from insurance verification to reconciliation, making a meaningful impact by securing reimbursements for essential lodging services.

Responsibilities

• Verify insurance eligibility and obtain lodging and travel prior authorizations through OHP, Medicaid programs, CCOs/MCOs, NEMT brokers, and private insurance payers
• Gather stay documentation, review charges and authorizations, and prepare and submit accurate claims and invoices according to payer requirements
• Monitor outstanding receivables, investigate denials, correct and resubmit claims, and prepare appeals within required deadlines
• Reconcile payments, allocate reimbursements to the appropriate location, maintain billing records, and prepare reports on receivables and collection performance
• Maintain HIPAA-compliant, audit-ready records and collaborate with payers and internal teams to resolve documentation and reimbursement issues

Requirements

• Two or more years of medical, Medicaid, or third-party billing and collections experience
• Working knowledge of claims submission, denial management, and appeals processes
• Understanding of HIPAA requirements and proper handling of protected health information
• Proficiency in Microsoft Office, particularly Excel, and experience using payer web portals
• Strong attention to detail, organization, and deadline management, with effective written and verbal communication skills

Important Details

• Schedule: Full-time; Monday–Friday | 9:00am–5:30pm

Physical Requirements

• This role involves primarily office-based computer and phone work, requiring the ability to sit for extended periods and use a computer for most of the workday

About the Company

This position is offered through NW Staffing Resources.