Contracts and Billing Specialist

Job Description

Job Description

Job Summary

The Contracts and Billing Specialist is responsible for preparing, processing, and tracking Medicaid Waiver prior authorizations, service contracts, invoices, and related documentation. The position also supports billing, donation tracking, and financial recordkeeping. Working collaboratively with Care Coordination, Finance, Development, and program leadership, this role ensures accuracy, timely processing, compliance, and effective communication across departments.

Supervisory Responsibility

None.

Essential Job Functions

Prior Authorizations and Contracts

• Prepare, submit, revise, and track Medicaid Waiver prior authorizations, ensuring accurate information, complete documentation, and timely follow-up on pending approvals.
• Prepare and maintain Waiver service contracts, including calculating amounts based on approved hours, units, and rates; processing amendments; and coordinating approvals and signatures with the COO.
• Monitor contract effective dates, expirations, and annual renewals to ensure contracts remain current and properly documented.
• Verify consistency between approved authorizations, contracts, and billing records, identifying and communicating discrepancies.

Billing and Invoice Processing

• Collect, review, enter, and track invoices from families and providers, ensuring accuracy and required supporting documentation.
• Assist with billing preparation, processing, reconciliation, and follow-up on outstanding invoices, payments, and documentation.
• Maintain accurate, organized billing and financial records to support timely reimbursement, reporting, and audits.

Donation Tracking

• Assist with recording, tracking, and reconciling donations and pledges in coordination with Development and Finance.
• Maintain accurate donor contribution records, monitor outstanding pledges, and assist with donation reports and information needed for donor acknowledgments.

Coordination and Compliance

• Collaborate with Care Coordination, Finance, Development, and program staff to resolve missing information, discrepancies, and issues affecting contracts, authorizations, billing, or donations.
• Maintain confidentiality and comply with HIPAA, Medicaid and payer requirements, applicable state regulations, and ERC policies and internal controls.
• Manage deadlines, maintain audit-ready documentation, and identify opportunities to improve accuracy, efficiency, and financial processes.

Qualifications – Knowledge, Skills, and Abilities

• Strong organizational skills, attention to detail, and ability to manage multiple deadlines.
• Working knowledge of basic accounting, billing, invoicing, and financial recordkeeping.
• Ability to review documentation, identify discrepancies, perform accurate calculations, and resolve problems.
• Proficiency in Microsoft Office, particularly Excel, and ability to learn billing, accounting, payer, and donor management systems.
• Strong communication, confidentiality, independent judgment, and collaboration skills.
• Ability to understand and follow applicable payer, contract, authorization, and regulatory requirements.

Required Education and Experience

• High school diploma, GED, or equivalent.
• Minimum two years of accounting, billing, accounts receivable, financial administration, or related experience.
• Proficiency with Microsoft Word, Excel, and electronic recordkeeping.

Preferred Education and Experience

• Associate or bachelor's degree in accounting, finance, business, or related field.
• Three or more years of relevant financial or billing experience.
• Experience with Medicaid Waiver programs, prior authorizations, contracts, or healthcare billing.
• Experience with nonprofit financial operations, donation tracking, or donor management systems.
• Experience with regulatory compliance, audits, or services for individuals with intellectual and developmental disabilities.

Work Environment and Physical Demands

Primarily office-based with extended computer and telephone use and routine sitting, standing, walking, and reaching. Occasional lifting of up to 20 pounds and moderate noise may occur.

Travel

Less than 10% local travel.

Additional Eligibility Qualifications

Must pass required background checks, comply with applicable drug testing requirements, have reliable transportation, and complete all required training, including HIPAA and applicable regulatory and safety training.

Other Duties

Perform other duties as assigned to support ERC operations and its mission. This description is not an exhaustive list of responsibilities or qualifications.

AAP/EEO Statement

The Elizabeth Richardson Center (ERC) provides equal employment opportunities to all qualified individuals without regard to any characteristic protected by applicable federal, state, or local law. This commitment applies to all aspects of employment, including hiring, compensation, training, promotion, and separation.