Billing Specialist

Job Description

Job Description

ESSENTIAL FUNCTIONS:

• Performs monthly full-cycle bill generation, billing corrections, reporting, reconciliation, and research on billing and/or related accounting issues and consolidates the monthly office and region billing totals for assigned service line(s)/region(s), through multiple billing systems.

• Devises centralized billing procedures and guidelines to ensure accurate and timely invoice management reporting.

• Serves as primary point of contact with California Regional Centers, DOR, Private Pay, and Third-Party Payors on POS, revenue relationships, and changes to revenue practices across multiple service lines.

• Prepare income worksheets for multiple service lines and multiple payors which include complex reconciliations.

• Reconcile multiple payors/multiple service lines direct deposits to cashbook.

• Maintains accurate authorization, rate, eligibility and utilization records to support compliance, service continuity, and billing accuracy. Collaborates with service teams to ensure billing practices and procedures with specific rates provided by Regional Centers and DOR.

• Reviews POS and billing data to identify risks, compliance gaps, operational needs, and growth opportunities.

• Supports cross-department collaboration to resolve billing issues.

• Partners with Program, Accounting, Finance, IT, and Compliance teams to resolve operational issues and implement system and policy changes.

• Provide support and collaboration in internal audits for multiple service lines/multiple payors. Support external audit activities related to POS, billing, and compliance. Implement automated solutions for secondary payor billing, correct coding, format errors, and denial of invoice payment.

• Produces and distributes a variety of documents associated with billing and/or receivables, such as correspondence, statements, reports, etc. to Regional Centers, DOR, families, and/or other entities upon request.

• Define and report on aggressive days sales outstanding, net collection rate, and ensure an ideal benchmark billing submissions are paid on the first submission without errors, rejections, or manual intervention.

• Performs other duties as assigned.

EXPERIENCE:

• Experience in revenue cycle billing optimization and full cycle collections management.

• 3-4 years of progressively responsible experience in Regional Center and DDS-funded services.

• Proven track record of leading complex projects from concept through deployment.

• Experience directing Regional Center and DDS initiatives.

• Strong analytical skills with proficiency in data analytics tools such as Excel and PowerBI.

• High attention to detail and accuracy in managing authorization and billing documents.

• Ability to interpret and apply regulatory requirements across service delivery environments.

• Bachelor’s degree or equivalent work experience.