Billing Specialist

Opportunities Inc•Lanham, MD

6d•$65,000

About The Position

Opportunities, Inc. seeks to ensure that all people with intellectual and developmental disabilities are provided chances to build a broad range of skills, gain new knowledge, interact with their community and, most importantly, be provided a variety of inclusive opportunities within the communities where they work, recreate, and live. We provide excellence in vocational, social, and adaptive skill development to help adults with disabilities achieve their fullest potential for independence and self-confidence. JOB SUMMARY: The Billing Specialist reports directly to the Chief Financial Officer and is responsible for a range of functions within the Finance Department. This role focuses on ensuring that billing is completed accurately, recorded and reconciled appropriately, and submitted within required timeframes for services provided through multiple funding sources, including the Developmental Disabilities Administration (DDA), the Division of Rehabilitation Services (DORS), and private pay arrangements. The Billing Specialist collaborates closely with the Chief Financial Officer and Program Managers to ensure that participant attendance and service documentation are accurate and sufficient to support all billed claims. The position requires proficiency in Maryland’s LTSS database system and includes regular review and maintenance of billing data within Opportunities, Inc.’s internal database (iCare Manager). In addition, the Billing Specialist assists with the annual audit process and provides ongoing support to the Chief Financial Officer to ensure efficient, well-coordinated Finance Department operations.

Requirements

Bachelor’s degree in a related field required.
Experience with the LTSS system within the State of Maryland
2-5 years’ experience working within a Finance Department, with a focus on claims billing and reconciliation
Experience with services and Support funded through the Developmental Disabilities Administration

Nice To Haves

Knowledge/experience regarding the iCareManager database system
Creative and detail-oriented
Proven initiative and self-starter attributes
Excellent analytical, problem-solving, and troubleshooting abilities, with strong data analysis acumen, and a focus on accuracy and attention to detail
Ability to effectively manage multiple priorities at the same time
Strong organizational and time management skills
Ability and willingness to work in a high-energy environment
Relates well to diverse populations; builds appropriate rapport
Outstanding communication and interpersonal skills
Strong ability in using Microsoft Office suites
Proficient in QuickBooks Online

Responsibilities

Manage the full billing lifecycle across all funding sources, including claim submission, exception resolution, denials, adjustments, rebilling, and recoupment tracking.
Submit weekly billing of Developmental Disabilities Administration (DDA)funded services into the Maryland LTSS database based on the Opportunities, Inc. billing schedule.
Review LTSS billing exceptions weekly and collaborate with designated internal and external stakeholders to resolve them in accordance with the protocol.
Closes each billing cycle, ensuring all items are billed at the end of the cycle; escalates issues and needs for billing date extensions to the CFO or an alternate member of leadership.
Track all submitted claims and complete regular reconciliation to ensure that payment for billed services is received and that payments are correct.
Maintain billing compliance by ensuring documentation, claims, and reconciliation processes meet DDA, Medicaid waiver, DORS, and other applicable regulatory requirements; support audits, program reviews, and corrective actions as needed.
Perform regular reconciliation and accounts receivable monitoring to ensure timely and accurate payment; identify variances, delayed payments, and revenue risks, and escalate to the CFO.
Works with program leadership to ensure that all documentation meets compliance requirements and supports billing activities prior to billing services.
Communicate with Program Managers when items are not ready for billing by the due date.
Develop, maintain, and improve billing procedures, internal controls, and process documentation; recommend system and workflow improvements based on trend and performance analysis.
Develop/update billing schedule and communicate any changes to Program staff.
Ensure data integrity across LTSS, iCare Manager, and financial systems by reviewing authorizations, service codes, rates, units, and eligibility to align attendance, documentation, and billing.
Conduct monthly reviews of eligibility in both LTSS and EVS for people on the service pause list, reporting the outcome of the review of both systems to identify cases where funding has been reinstated without notification through alternate means.
Share eligibility review findings via email with C-suite members, Program Manager, and Support Coordinators for each individual reviewed.
Communicate all issues related to the billing of services in LTSS to dedicated program staff and the Chief Financial Officer, including but not limited to requesting an extension to close the billing cycle.
Communicate with DDA Regional office(s) to report issues with the LTSS system, and/or any significant billing issues not caused by internal procedures.
Complete and submit “State-Only” funded billing for individuals who are not enrolled in any 1915(c) waiver services.
Complete the monthly billing process for all services funded through Self-Direction or Private pay. Ensure accurate input of Self-Direction and Private pay invoices in the organization’s accounting software.
Complete the monthly billing process for all services funded through the Division of Rehabilitation Services, all needed supporting documentation from the program, and upload to the DORS billing portal.
Support operational continuity by maintaining organized billing records, assisting with staff training on documentation requirements, and cross-training within the Finance Department.
Track billing trends and data over time and report any anomalies to the CFO.
Keep current with LTSS updates and news.
Create invoices in QuickBooks Online for all billed services to ensure the accurate tracking of revenue in the organization’s accounting software.
Participate in cross-functional teams, as assigned, to address organizational needs and promote collaboration across departments in support of Opportunities Inc.’s mission.