Billing Specialist

MEDICAID BILLING SPECIALIST 

REPORTS TO:
Director of Business Administration 

QUALIFICATIONS: 

• High school diploma or GED ; Associate’s degree in business, accounting, healthcare administration, or related field preferred. 

• Minimum of two years of experience in Medicaid billing, insurance claims processing, or healthcare reimbursement. 

• Knowledge of Medicaid rules and regulations specific to Texas . 

• Familiarity with billing software systems and electronic health records (EHR); experience with Theranest or similar platforms is a plus. 

• Demonstrated proficiency in Microsoft Office Suite (Excel, Word, Outlook). 

• Strong attention to detail, organization, and time-management skills. 

• Experience working in a faith-based or non-profit organization preferred. 

Primary Purpose: 
Ensure timely, accurate billing and reimbursement of Medicaid claims for mental and behavioral health services provided by Hope Haven of East Texas. Collaborate with program and administrative staff to maintain compliance with billing standards and support financial operations essential to sustaining care for children and families. 

Compensation Status: Full-Time Salaried (Exempt) 

GENERAL RESPONSIBILITIES AND DUTIES 

Billing and Claims Processing 

• Prepare, submit, and track Medicaid claims for behavioral health and residential services. 

• Verify client eligibility and authorization prior to services being billed. 

• Resolve billing discrepancies, denials, and rejections by coordinating with providers and Medicaid offices. 

• Maintain accurate billing records and documentation for audit readiness and reporting. 

Compliance and Standards 

• Ensure adherence to Medicaid billing guidelines, HIPAA regulations, and Texas Department of Family and Protective Services requirements. 

• Conduct routine internal audits of billing practices and documentation. 

• Stay informed of Medicaid updates, billing rule changes, and ensure processes are adapted accordingly. 

Collaboration and Communication 

• Work closely with therapists, case managers, and administrative staff to ensure billing accuracy and completeness. 

• Assist in staff training on billing-related documentation requirements. 

• Communicate effectively with managed care organizations and state agencies to resolve issues. 

• Help schedule clients for sessions 

Reporting and Financial Reconciliation 

• Generate monthly, quarterly, and annual reports related to billing and collections. 

• Reconcile payments and remittances with agency financial systems and escalate discrepancies. 

• Assist Finance Director with budget projections and reimbursement forecasting. 

Organizational Leadership 

• Participate in internal meetings, case reviews, and planning sessions as needed. 

• Support the mission of Hope Haven by demonstrating integrity, stewardship, and professionalism in all financial dealings. 

• Uphold the Christian values and faith-based mission of Hope Haven in all responsibilities and interactions. 

Position Requirements, Knowledge, SKILLS, and Abilities: 

• Strong knowledge of Medicaid billing systems and requirements. 

• Ability to prioritize work, manage multiple deadlines, and adapt to changing regulatory environments. 

• Excellent communication skills, both verbal and written. 

• Strong ethical standards and commitment to confidentiality. 

• Team player with a heart for service and ministry to vulnerable children and families. 

• Willingness to engage with the faith-centered mission of Hope Haven of East Texas and demonstrate respect for its values and culture. 

This position requires the positive completion of a 90-day probationary period. During this time, the agency and employee will decide if the professional relationship is cohesive. At any time during the 90-day probationary period, either the agency or employee may terminate the relationship for any reason.