Strong familiarity with Medicaid billing portals, commercial insurance structures, and clearinghouses.
Proficiency with electronic health record (EHR) or billing software and Microsoft Office.
Working knowledge of HIPAA guidelines and commitment to maintaining strict client confidentiality.
Exceptional attention to detail, strong problem-solving abilities, and clear verbal and written communication skills.
Responsibilities
Review session notes, attendance logs, and service records for accuracy and completeness before billing.
Code and submit clean electronic or paper claims to Medicaid, state agencies, and private insurance providers.
Ensure adherence to state-specific early intervention regulations, billing guidelines, and coding standards.
Verify patient health insurance eligibility, coverage limits, and active policy status prior to service delivery.
Track, enter, and update service authorizations, including units, frequency, and duration, in the billing software.
Coordinate with coordinators and clinical providers to resolve missing or expired authorizations.
Monitor Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to post payments and adjustments accurately.
Research, correct, and promptly resubmit rejected or denied claims.
Follow up on aging accounts receivable and persistent unpaid claims.
File formal insurance appeals when legitimate claims are underpaid or wrongfully denied.
Communicate with families to explain insurance benefits, copays, or billing statements.
Collaborate with early intervention program staff and case managers to resolve documentation, demographic, or scheduling discrepancies.
Provide regular reports to management regarding billing metrics, revenue trends, and recurring denial patterns.
Description
Reports To: Program Director Employment Type: Full-Time
Position Summary
The Early Intervention Billing Specialist is responsible for ensuring the accurate and timely processing of insurance claims, managing service authorizations, and securing proper reimbursement for early intervention (EI) services. This role acts as a key bridge between clinical/program staff, families, and funding sources—including Medicaid, state early intervention programs, and private commercial insurance.
Key Responsibilities
Claim Preparation and Submission
· Review session notes, attendance logs, and service records for accuracy and completeness before billing.
· Code and submit clean electronic or paper claims to Medicaid, state agencies, and private insurance providers.
· Ensure strict adherence to state-specific early intervention regulations, billing guidelines, and coding standards
Insurance Verification and Authorizations
· Verify patient health insurance eligibility, coverage limits, and active policy status prior to service delivery.
· Track, enter, and update service authorizations (units, frequency, and duration) in the billing software.
· Coordinate with coordinators and clinical providers to resolve missing or expired authorizations
Accounts Receivable (AR) and Denials Management
· Monitor Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to post payments and adjustments accurately.
· Research, correct, and resubmit rejected or denied claims promptly.
· Proactively follow up on aging accounts receivable (AR) and persistent unpaid claims.
· File formal insurance appeals when legitimate claims are underpaid or wrongfully denied
Communication and Collaboration
· Communicate professionally with families to explain insurance benefits, copays, or billing statements.
· Collaborate closely with early intervention program staff and case managers to resolve documentation, demographic, or scheduling discrepancies.
· Provide regular reports to management regarding billing metrics, revenue trends, and recurring denial patterns
Requirements
Qualifications & Skills
Education: High school diploma or equivalent required
Knowledge Base: Strong familiarity with Medicaid billing portals, commercial insurance structures, and clearinghouses
Technical Skills: Proficiency with electronic health record (EHR) / billing software and Microsoft Office
Soft Skills: Exceptional attention to detail, strong problem-solving abilities, and clear verbal and written communication skills
Compliance: Working knowledge of HIPAA guidelines and commitment to maintaining strict client confidentiality.
What we offer:
Comprehensive benefits, includinghealth, dental, vision, and retirement/401(k) with company matc