Billing Specialist – Substance Abuse Treatment Operations
ALL IN SOLUTIONS
PHP
Senior Billing Specialist
Maven Clinic
full-time
Posted on:
Location: California, Colorado, New York • 🇺🇸 United States
Visit company websiteSalary
💰 $100,000 - $120,000 per year
Job Level
Senior
Tech Stack
Maven
About the role
- Lead the resolution of complex financial and benefits billing escalations, serving as a key expert to ensure accurate member financial tracking and provide equitable solutions for members, employers, and insurers.
- Investigate and resolve escalated cases involving billing errors, incorrect benefit calculations, eligibility disputes, overpayments, insurance review and balance mismatches.
- Perform root-cause analysis on multi system issues (e.b, billing delays, data reconciliation, error tracking) and coordinate corrective actions—such as claim adjustments, accumulator adjustments, or balance reconciliations—with internal and external partners.
- Act as the primary bridge between Operations, Product and Engineering, Support, Customer Success, Finance, Employers, and Payers to clarify issues and expedite resolutions.
- Reconcile claims data, denial reports, and finance outputs across many platforms to ensure accurate benefit balances and member statements.
- Track cases through resolution; maintain meticulous issue documentation across multiple systems.
- Proactively identify trends in escalations; propose and implement systematic process improvements to reduce recurrence.
- Communicate clearly and compassionately with members and stakeholders about resolution steps, outcomes, and next actions.
Requirements
- Bachelor’s degree in Healthcare Administration, Finance, Business, or related field; or equivalent experience preferred
- 3+ years of relevant experience in medical billing, health benefits, or escalation management
- Proven ability to handle complex billing escalations (e.g., accumulator discrepancies, eligibility, overpayments, billing corrections).
- Deep understanding of claims lifecycle, benefits design, accumulations logic, AR workflows, and insurance adjudication.
- Familiarity with billing systems (EHRs, clearinghouses), issue tracking tools (Zendesk, Jira, etc.), and data/reporting platforms (Google Sheets, Looker).
- Highly detail‑oriented and structured, with strong organizational skills
- Excellent critical‑thinking skills for root‑cause analysis and effective resolution of multi‑stakeholder issues.
- Outstanding verbal and written communication, adept at translating billing data into clear, confident, and definitive recovery plans for all stakeholders.
- Strong cross‑functional collaboration with member services, care, finance, employers, providers, and insurers.Empathy-driven and member‑centric in handling escalated cases
- Comfortable adapting to shifting priorities in a fast-paced environment.
- Creative problem-solver with resourcefulness to drive innovative escalations strategies.
