Medicaid Billing Specialist

Medicaid Billing Specialist

Direct Supervisor: Controller

Benefits: Part-time (20hrs/week), Non-Exempt with some qualifying benefits: Blue Cross Medical/Dental/Vision, 403(b) Retirement Plan, Holidays, Paid Time Off, 10 weeks paid Parental leave, EAP,  

Salary: $26.58/hr

Alternatives Overview

Our mission is to inspire young people to create a just future through practices that heal individuals, restore communities, and transform systems. Since 1971, Alternatives has modeled innovative alternatives to the status quo in Chicago's youth services field. Our school and community-based therapy, prevention and leadership development programs support young people to individually and collectively address causes of substance abuse, grief and trauma while building social-emotional, career and social change skills. In addition to working directly with young people, we train, coach and advocate for youth-serving institutions like Chicago Public Schools to be restorative and trauma-informed.

Position Overview

 Alternatives is a Behavioral Health Clinic (BHC) and Substance Use Prevention (SUD) organization. We bill a state contract for SUD services and Medicaid/MCO’s for both the BHC and SUD services. The Billing Specialist will be responsible for ensuring timely and accurate billing for both services. The Billing Specialist will be responsible for correcting billing errors, tracking appeals and rejections and maintaining an 80% collection rate. The Billing Specialist will work collaboratively with the Clinical team and the Finance team to monitor the medicaid revenue cycle. 

Responsibilities

Perform the following from a racial, gender, sexuality, and ability equity lens:

• Submit billing claims that are timely and accurate with correct CPT/ICD10 codes, modifiers, units and amounts. 
• Resolve rejections/denials on a routine and timely basis
• Post and reconcile payments 
• Monitor and follow up on outstanding AR
• Collaborate with the Clinical Team to ensure accurate coding
• Communicate with Clinical Supervisors regarding documentation and coding clarification
• Ensure compliance with payer guidelines, Medicaid and HIPAA regulations
• Use the finance accounting software to track receivables
• Act as a liaison between the Finance Department the Clinical team
• Maintain a collection rate of at least 80%
• Provide monthly billing report updates to Executive Team 
• Upload DARTS admissions and discharges 
• Bill DARTS accurately and and timely

Qualifications

Medical Billing Certification or 3+ years of Medicaid Billing experience 

Experience with Qualifacts/Insync required

Experience with DARTS Preferred

Proficiency with Innovalon and Availity

Proficiency with Google Workspace & Microsoft

Strong organizational skills that reflect excellent attention to detail.

Strong knowledge of CPT and ICD-10 coding