Billing & Claims Specialist - Bilingual (Spanish)

SafeRide Health•San Antonio, TX

About The Position

SafeRide Health is looking for a hands-on Claims Specialist to scale SafeRide. We are looking for a leader with deep experience managing Medicare and Medicaid programs as we scale past $100M in annual revenue. The Billing Specialist is responsible for elevating SafeRide’s billing function and continuously enhancing the effectiveness of the organization. Strong business and financial orientation as well as a passion for growth and development are critical for this role.

Requirements

Minimum 1 years of experience in billing/claims management
Must be bilingual Spanish Speaking
Strong data skills in Excel/Sheets, including pivot tables, v-lookups, etc.
Self-starter, ability to work independently and in a team environment.
Strength in problem solving, applying hard data and qualitative insight to frame problems and develop novel solutions
Ability to adapt to unforeseen circumstances quickly
Keen attention to detail
Ability to work with a variety of stakeholders

Nice To Haves

NEMT/transportation background preferred
Knowledge of CMS/HHSC regulations preferred

Responsibilities

Facilitates data processing and processes claims for NEMT and GMR rides.
Performs reconciliation of billing data to encounter data.
Works closely with the operations team to resolve issues.
Work with internal operations and project teams to solve claims-related problems, benefit plans research and provider contract interpretation and configurations.
Communicate and work with providers to get claims issues resolved and paid accurately and in accordance with healthcare/Medicare/Medicaid regulations, policies, and payment policies and guidelines.
Receive incoming calls from providers, customers, vendors, and internal groups, to successfully analyze the caller's needs, research information, answer questions, and resolved issues and/or disputes in a timely and accurate manner.
Identify issues negatively impacting the provider community including but not limited to system set up, required benefit modifications, EDI logic, provider education, claim examiner errors, and authorization rules.
Develops and implements policies, processes and procedures that incorporate industry best practices, and reinforces high quality standards within the Billing team.
Served as the Billing team’s subject matter expert and primary contact for claims related projects and critical activities.
Mentors junior team members and provides internal claims team training, coaching, guidance, and assistance with complex issues.
Implement scalable and accurate billing operations systems leveraging best in class technology. This includes financial reporting for management, clients and designated state and federal agencies (e.g., HHSC in Texas).
Champion and reinforce SafeRide’s culture.