Billing Specialist

• Provide accurate billing information to deliver sustainable, mission-driven services.
• Manage the Electronic Visit Verification (EVV) system for Community-Based Services.
• Run and reconcile bi-weekly EVV reports.
• Review, document, and correct inaccurate EVV entries.
• Manage CBS staff schedules within the EVV system.
• Collaborate with program supervisors and staff to resolve scheduling or EVV-related issues.
• Maintain current knowledge of Federal, State, and Office of Developmental Programs (ODP) EVV regulations and requirements.
• Access, maintain, and distribute Individual Support Plans (ISPs) from HCSIS.
• Assist with data entry related to Virtual Program billing and Meaningful Day CPS billing.
• Enroll new admissions into EVOLV.
• Complete special projects, assignments, and additional duties as assigned.

Program Billing Coordinator – Community Based, Virtual Services

• Coordinates and facilitates patient billing and collection activities
• Processes payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications
• Researches payments, denials, and accounts
• Builds strong working relationships with assigned business units

PFS Representative, CBO Billing, Follow-up, Denials Management

• Process client invoices in volume
• Work closely with internal and external clients
• Establish billing parameters upon receipt of a new or updated client contract
• Create client invoices accurately and timely that correspond to the terms of the contract
• Consistently review and confirm invoice details across requisite systems
• Apply credit memos as needed with documentation
• Respond timely to client inquiries
• Track & Report A/R Aging to clients
• Assist Collection Specialists on aged client invoices
• Research discrepancies and provide audit support & schedules as needed

• Track and monitor the submission and acceptance of e-billed invoices through eBillingHub and specific vendor sites.
• Assist Billing Coordinators as needed to help resolve submission issues, including appeals of rejections and reductions.
• Check for new matters and rate approvals on vendor sites and work with the Billing team to ensure data integrity in Elite 3E.
• Work with Billing Coordinators to submit invoices to vendor sites via eBillingHub in accordance with Outside Counsel Guidelines.
• Ensure invoice acceptance in vendor sites such as Legal Tracker, T360, and others.
• Perform a first-level attempt to correct e-billing issues such as fixing block-billing and task codes, and resubmit any rejected invoices.
• Monitor vendor sites for newly created matters and work with Billing team to set up matters in 3E.
• Review vendor sites for timekeeper rate approvals and communicate rate adjustments to Billing and Pricing teams as necessary.
• Assist the e-billing Supervisor in suggesting actions the Billing team might take in the future to avoid reductions and rejections of certain line items.
• Other duties as assigned by the E-Billing Supervisor.

E-Billing Coordinator

• Perform billing and accounts receivable functions by working collaboratively with Support Specialists, consulting staff, and other associates to support the enterprise’s initiatives.
• Assist with project management and train other associates.
• The Billing Operations Specialist is responsible for delivering timely and accurate client billing across the enterprise.
• This role supports accounts receivable, billing quality assurance, and invoice processing, while also providing secondary operational support for associates that may include, but is not limited to, travel and associate expense operations, scheduling, and client team support on various administrative client matters.
• Working closely with the Revenue Operations and Systems Manager, this position partners with Finance, HR, IT, consulting staff, and client teams to ensure billing accuracy, maintain policy compliance, and identify process improvements.
• The Specialist also contributes to documentation, training, and project management activities to enhance enterprise-wide financial operations.
• Conduct monthly billing QA reporting, including pre-bill adjustments, mark-ups, invoice consolidations, addition of value-added fees and data charges.
• Analyze client work in progress (WIP), prepare and format invoices, coordinate approvals and finalize or reinstate when needed.
• Work with consultants to modify invoice details, enter new clients and project codes, and maintain accuracy and compliance with contract specifications.
• Assist client teams with accurate capture and approval of billable time and expenses.
• Submit finalized invoices by auto e-bill or client-specific portals, ensuring write-offs are properly documented and approved.
• Monitor accounts receivable balances, aged receivables and WIP; resolve billing issues and client inquiries.
• Maintain accurate client billing information updating in coordination with associates and client teams.
• Serve as a subject matter expert on the enterprise’s billing process and related software.
• Continually identify and implement process improvements in billing, time tracking, and travel expense workflows in collaboration with Shared Services departments and business unit leaders.
• Process or serve as a backup for staff record updates (new hires, role changes, permissions) in coordination with HR.
• Help maintain system integrity and assist with upgrades, integrations, and administration of billing, timekeeping, and expense management platforms.
• Assist with project management activities in support of Finance and Operations initiatives, and support travel coordinators with expense submissions.
• Train associates and consulting staff on billing and expense procedures, systems, and best practices.
• Support administration of the organization’s T&E policy by reviewing and monitoring expense submissions and corporate card activity, ensuring compliance with IRS and internal guidelines, and escalating policy exceptions as needed.
• Contribute to internal communications, documentation, and knowledge sharing to ensure consistency across teams.
• Manage special projects, provide subject matter expertise, and train or mentor other billing support staff.
• Interact with department leaders, consultants, or other associates to troubleshoot complex issues.
• Reissue approved reinstated invoices when changes are required.
• Assist with creating and maintaining documentation of procedures regularly to ensure they are up to date and accurate.

Billing Operations Specialist

• Monitors and coordinates technical lab billing issues.
• Assists with day to day operational oversight of billing department and ensures daily duties are completed per established guidelines.
• Troubleshoots billing issues and takes appropriate actions.
• Assists customers with patient billing inquiries.
• Identifies unpaid balances (insurance and patient) through A/R reports and takes appropriate actions.
• Supervises work performed by billing staff.
• Maintains current knowledge of federal and state reimbursement policies/regulations and system policies.
• Ensures compliance with regulatory requirements.
• Obtains and enters patient demographic, insurance, and referral/precertification information in the billing system.
• Verifies insurance information via hospital and insurance carrier systems.
• Performs all other duties as assigned, including but not limited to supporting front end office processes.

Billing Coordinator

• Supports the complete and timely collection of revenue for assigned groups by performing accurate coding and entry of patient and charge information into the billing system.
• Tracks all high dollar claims from charge entry to payment and resolves complex carrier issues.
• Actively follows up on outstanding complex claims/or charges.
• Reviews and resolves complex issues that result in payer denials, including appeals, coding corrections, medically necessity rules and other related functions.
• Assists the auditor in reviewing notes for medical necessity.
• Works with the authorization department to resolve authorization issues with complex procedures.
• Runs and maintains tracking logs to track complex high dollar procedures and report the results to the billing department management team.
• Contacts the various Provider Service Representatives to resolve repetitive payment issues.
• Acts as a resource for the Billing Staff for complex issues.
• Analyzes and resolves billing issues, keeping A/R to no more than 10% over 60 days.
• Processes daily correspondence, claim status, handle denials, appeals and re-bills.
• Answers billing questions and inquiries from patients and internal staff.
• Updates patient files with address changes, contact information changes, etc., as needed.
• Reviews all policy changes on a regular basis and informs supervisor and charge entry specialist of such changes.
• Efficiently navigates assigned insurance companies' proprietary websites to find policies, research payments, etc.
• Keeps supervisor apprised of matters regarding accounts receivable.
• Responds to requests from billing company in a timely fashion.
• Researches denials and submits correct claims/medical documentation.
• Reviews and manages claims within the work dashboard hold buckets for resolution.
• Creates, maintains and updates reports, as directed.
• Exercises confidentiality in all areas, abiding by HIPAA rules and regulations.
• Helps train new revenue cycle staff.
• Collects and reviews end of day reports.
• Checks work e-mail on a regular basis throughout the workday.
• Participates in and completes all required trainings and in-services.
• Performs other duties as assigned.

Billing Specialist II

• Ensures timely and accurate payment for services rendered
• Manages accounts receivable and engages in effective communication with payers, clients, and other stakeholders
• Resolves problems by clarifying issues and implementing changes to maximize timely and complete reimbursement
• Monitors and manages accounts receivable, ensuring timely collection of payments
• Utilizes electronic billing systems and software to maintain accurate billing records
• Collaborates with the billing team for accurate claim submissions
• Provides support related to Revenue Cycle and billing, collections, and Electronic Visit Verifications (EVV)

Billing Coordinator II

• Generate and distribute pre-bills monthly and as requested
• Process narrative edits, time, and cost adjustments
• Process final invoices
• Generate LEDES and other file formats for electronic billing
• Submit electronic billing using various vendor website
• Ensure successful transmission of E-Bills and follow up when necessary
• Maintain accurate and orderly records of all client guidelines
• Implement and maintain correct client exception rates on matter/client, where required
• Manage “book of business” by maintaining current information on attorney preferences, proforma status, and billing cycles

• Perform timely follow-up on outstanding insurance claims and unpaid accounts
• Investigate and resolve claim denials, rejections, and underpayments
• Post insurance and patient payments accurately and reconcile discrepancies
• Identify trends in denials or payment issues and escalate as needed
• Work aging reports and prioritize accounts based on timely filing and payer guidelines
• Communicate with insurance companies to obtain claim status, reprocess claims, or correct errors
• Submit corrected claims, appeals, and supporting documentation as needed
• Collaborate with coding and front-end teams to resolve billing issues at the source
• Maintain accurate account documentation and follow-up notes in the system

• Conducts advanced data analysis, data validation, and reporting
• Ensures integrity of data flowing into the billing systems is accurate and complete
• Identifies, develops, documents, and implements process improvements within existing billing platforms and processes
• Assists in automating billing production files
• Participates in internal/external audit testing
• Runs reports through internal accounting system, Intacct, for analysis on accounts receivable
• Enters/uploads information into the billing system and calculates amounts due
• Prepares invoices, listing services provided and amounts due
• Prepares/processes credit memorandums on invoice to correct line items
• Posts transactions to accounting records such as worksheet, ledger or computer files
• Provides customer service to internal and external customers and may work closely with third party partners.
• Performs ad-hoc analysis and reporting for client specific inquiries

Billing Analyst II

• Communicate effectively to resolve discrepancies
• Process and maintain membership data
• Perform billing and accounts receivable activities
• Create and distribute membership materials

Billing Specialist jobs in Pennsylvania

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Program Billing Coordinator – Community Based, Virtual Services

PFS Representative, CBO Billing, Follow-up, Denials Management

Billing Specialist

E-Billing Coordinator

Billing Operations Specialist

Billing Coordinator

Billing Specialist II

Billing Coordinator II

Billing Specialist

Billing Coordinator

Billing Analyst II

Enrollment and Billing Representative