Ultimate Staffing · 1 day ago
Billing Compliance Specialist
Ultimate Staffing is seeking a Billing Compliance Specialist to support their Quality Assurance & Compliance department. The role involves verifying DMH funding eligibility, reviewing admissions and discharges, and ensuring client billing readiness through accurate data management in the Electronic Health Record System.
Responsibilities
Verify DMH funding eligibility at admission and monthly; update and maintain client financial information in the Electronic Health Record System (EHRS). Notify programs of any changes or updates
Review daily admissions and discharges in EHRS to ensure client administrative facesheets are complete. Maintain an organized tracking system for assigned programs
Review and confirm client billing readiness by verifying IBHIS facesheets and financial information; submit all client call information to Client Web Services (CWS)
Review non-final saved charges daily in EHRS; complete corrective actions, update service charges, and final save charges so they can be batched for billing
Review Diagnosis and Financial Update Reports daily; ensure any required changes are updated in CWS once EHRS data is complete
Run monthly Non-Final Saved Notes reports for assigned programs and send follow-up to programs for action
Review Final Saved Charge reports before batching claims for DMH electronic submission to ensure correct funding source, provider number, and accuracy of all claim data
Batch reviewed claims and forward for submission to IBHIS
Qualification
Required
Minimum 2 years of experience working with Electronic Health Record (EHR) systems
Minimum 2 years of experience processing healthcare billing claims
Experience reviewing, correcting, and finalizing service charges
Ability to analyze billing discrepancies and reconcile reports
Understands medical terminology
Ability to read diagnoses, financial updates, and clinical documentation relevant to billing
Preferred
Experience with billing or payer platforms preferred (IBHIS, CWS, myEvolv/EHRS)