Billing Compliance Specialist 1
About The Position
Under direct supervision, this role is responsible for gathering billing documentation, verifying client eligibility, and confirming/entering service rates for budget planning for waiver and state plan services. The specialist identifies, reviews, and submits billable services to capture revenue from various funding sources, verifies and processes billing claims, and ensures the accuracy of budget data. This position also reconciles waiver budgets and utilizes several county and state computer programs (SSIS, MAXIS, MnCHOICES, and MMIS) to process client eligibility. The role requires maintaining knowledge of state service plans and waiver billing systems to provide ongoing support for Health Housing and Human Services, and monitoring changes in program standards and expectations to ensure budget and billing compliance. The specialist will also support a diverse, respectful, and inclusive workplace.
Requirements
- Associate’s degree from an accredited college or university in business, administrative assistant, accounting, or related field and one (1) year of experience in a similar position as listed in the work functions.
- OR Combination of education and experience equivalent to three (3) years of experience in a customer-focused position.
- Regular and reliable attendance is a necessary component of job/position.
- Individuals required to use County vehicles and equipment must have a valid driver’s license and be free of any major traffic violations for the last three (3) years.
- Knowledge of department programs, operations, policies, and procedures.
- Knowledge of the federal and state laws and rules for state programs.
- Knowledge of community resources.
- Knowledge of billing and claims processing.
- Skill in the use of basic business math.
- Skill in the use of computers and technology, including databases and Microsoft Office products.
- Skill in de-escalation techniques.
- Ability to gather and analyze information.
- Ability to effectively organize and prioritize work and meet deadlines.
- Ability to establish and maintain effective working relationships with others.
- Ability to communicate effectively both verbally and in writing.
- Ability to establish and maintain accurate records.
- Ability to train staff members.
- Must be currently authorized to work in the United States.
Nice To Haves
- Experience with SSIS, MAXIS, MnCHOICES, and MMIS.
Responsibilities
- Collects, verifies, and analyzes information for compliance with program rules and regulations to ensure accurate and timely billing for eligible revenue.
- Completes and submits documents, reports, and billings.
- Reviews reports, identifies missed claims, and determines correct information to resubmit.
- Enters and maintains data and makes updates to systems to ensure data integrity.
- Verifies and monitors eligibility for programs and communicates status.
- Conducts regular data checks in state and federal databases.
- Responds to audit requests.
- Provides information and reports to management.
- Conducts training on program revenue requirements.
- Develops and maintains documentation for procedures and workflows.
- Assists staff in navigating and troubleshooting the use of systems.
- Collaborates with staff, community partners, and health plans to ensure accurate payments.
Benefits
- Benefits package ensures your wellbeing
- Career advancement opportunities
- Professional development
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
