Billing Specialist

Overview

This role involves managing the accurate and efficient processing of billing and reimbursement for services provided across multiple programs, including Unconditional Education Outpatient, UE Mosaic, UE Constellation, and UE Ala Pathways Medical. The Billing Specialist is responsible for preparing, submitting, and tracking insurance claims, reconciling payments, and serving as a key contact for billing inquiries.

Responsibilities

• Prepare and submit accurate claims, invoices, and required documentation, including coding diagnoses and procedure codes.
• Monitor and track claims to ensure timely submission; investigate and resolve billing inaccuracies and issues.
• Verify client eligibility and benefits, including checking for additional private health insurance.
• Collaborate with funders and insurance companies to resolve billing inconsistencies and errors.
• Communicate with program and quality assurance staff regarding changes to client eligibility.
• Bill and collect copays/deductibles from parents or guardians where applicable.
• Upload files to relevant systems to apply payments and adjustments; generate reports from electronic health record (EHR) systems.
• Review billing denial queues and related reports daily to ensure timely processing; resubmit claims as needed.
• Coordinate with program staff to correct or update documentation.
• Input, complete, and review billing and payment invoices using internal and external EHR and clearinghouse systems; submit reports promptly.
• Maintain proper documentation for each claim, including approvals or denials, using appropriate county forms and systems.
• Reconcile payments and resolve discrepancies; work with payers to appeal and correct errors.
• Stay current on changes in billing codes, regulations, and payer policies.
• Attend all required trainings and meetings.

Qualifications

• Education and experience:
  • Bachelor’s degree OR
  • Associate degree plus 1 year of relevant work experience OR
  • High school diploma/GED plus 2 years of relevant work experience.
• Relevant experience includes data entry, claims processing, and revenue cycle billing.
• Familiarity with most medical insurance payors, including Medi-Cal and commercial insurance, preferred.
• Strong computer skills with high proficiency in Excel.
• Demonstrated organizational, analytical, and problem-solving skills.
• Extremely detail-oriented with strong abilities in organizing, tracking, and maintaining large volumes of information.
• Must be at least 21 years of age.
• Required clearances: TB test, fingerprinting, and any other applicable state or federal licensing or certification.

Schedule

• Full-time, remote position
• Monday through Friday, 9:00 AM to 5:30 PM

Compensation & Benefits

• Hourly rate starting at $28.41 to $30.91, dependent on experience above minimum qualifications
• Annual salary increases
• Five weeks of paid time off and 11 paid holidays
• Comprehensive benefits package including:
  • Medical, dental, vision, chiropractic, acupuncture, and fertility coverage
  • 50% paid premiums for dependents
  • Long-term disability, family leave, and life insurance
  • 403(b) retirement plan
  • Employer-paid employee assistance program
• Scholarship opportunities, ongoing training, and professional development
• Eligibility for Public Service Loan Forgiveness
• Opportunities for promotion within the organization across California and Washington

Location

• Remote work arrangement supporting multiple programs in assigned regions