Billing Specialist

Position Purpose:

The primary purpose of this position is to manage and oversee the billing process for Medicaid-funded and other reimbursable services, ensuring compliance with federal, state, and funding agency regulations. This role is responsible for verifying service documentation, submitting accurate claims, reconciling billing discrepancies, and supporting audits and compliance efforts. The position works closely with internal teams and external partners, including case managers, employment specialists, managed care organizations (MCOs), and state agencies-to ensure timely and accurate invoices that support program sustainability. Additionally, the role contributes to the continuous improvement of billing processes and systems, staying informed on policy changes and funding trends related to services for individuals with disabilities.

This position is remote, and the successful candidate must reside in the Hampton Roads area.

Primary Duties:

• Process and submit Medicaid claims for Medicaid-funded services, ensuring compliance with state and federal regulations.
• Verify billing data, authorizations, service documentation, and contracts before invoicing.
• Ensure accuracy of documentation in accordance with Medicaid, private/commercial insurance, and grant funding requirements.
• Monitor and reconcile documentation, following up on outstanding documentation, claims, and denials.
• Work closely with internal customers, case managers, job coaches, and employment specialists to ensure service documentation meets billing requirements.
• Assist in audits and compliance reviews, ensuring all records are properly documented and maintained.
• Communicate with internal partners, state agencies, managed care organizations (MCOs), and funding partners to resolve billing discrepancies.
• Review MCO to ensure it correlates with monthly Medicaid inquiries.
• Generate billing reports and provide financial insights to leadership to support program sustainability. Communicate with supervisors and/or managers about trends and areas of concern.
• Stay up to date with Medicaid policy changes, employment service funding models, and emerging trends in the future of work for individuals with disabilities.
• Support electronic billing system implementation and process improvements for efficiency.

Knowledge, Skills and Abilities:

• Medicaid Regulations & Billing Practices - Strong understanding of Medicaid, managed care organization (MCO) billing, and applicable federal and state regulations.
• Insurance & Funding Guidelines - Familiarity with Medicaid eligibility verification, private/commercial insurance billing practices, and grant-funded service documentation requirements.
• Medical/Service Coding Systems - Knowledge of billing codes and procedures relevant to Medicaid-funded employment and support services.
• Audit & Compliance Standards - Understanding documentation requirements and audit preparedness for healthcare or human services billing.
• Program Funding Models - Awareness of employment service funding models and trends related to services for individuals with disabilities.
• Strong Knowledge of Electronic Billing Systems - Experience with or knowledge of electronic billing platforms, claims processing systems, and financial reporting tools.
• Electronic Health Records (EHR) - Familiarity with EHR systems and state-specific Medicaid portals.
• Excel & Financial Reporting - Proficiency in Microsoft Excel and financial data analysis.
• Detail-Oriented & Problem-Solving - Strong analytical skills with the ability to identify and resolve billing issues.
• Communication & Collaboration - Effective verbal and written communication skills to work with service providers, funders, and internal stakeholders.
• Time Management & Multitasking - Ability to manage multiple tasks, meet strict deadlines, and prioritize workload efficiently.

Education:
Associate's or Bachelor's degree in Accounting, Finance, Healthcare Administration, or a related field preferred.

Experience:

• 2+ years of experience in Medicaid billing or healthcare-related billing.
• Experience working with disability services or human services organizations preferred.
• Experience working with TRAC IT (Tracking + Reporting + Coordinating for Infants and Toddlers) preferred.
• Familiarity with Vocational Rehabilitation (VR) funding, Workforce Innovation and Opportunity Act (WIOA), and other employment-focused programs.
• Experience working with nonprofits, community rehabilitation programs, or government-funded employment services.

VersAbility Resources Inc. is an equal opportunity employer and does not discriminate on the basis of any legally protected status or characteristic. Race/Color/Gender/Sexual Orientation/Gender Identity/Religion/National Origin/Disability/Veteran