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Insurance Billing & Compliance Specialist

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The Insurance Billing and Compliance Specialist is a specialist who performs hands-on billing and revenue cycle work. This person is the team’s go-to expert: when staff run into an issue they don’t know how to handle, they turn to the Insurance Billing and Compliance Specialist for the answer.

This role also owns regulatory compliance, provider credentialing, and licensure tracking. It ensures the clinic’s billing runs accurately, efficiently, ethically, and in line with our mission.

Bachelor’s degree in Healthcare Administration, Communication Disorders, Business, or a related field, or equivalent work experience.

· At least 3 years of hands-on medical billing and revenue cycle experience, including eligibility verification, prior authorizations, claims review, denial management and appeals, payment posting, and accounts receivable.

· At least 1 year of supervisory or team lead experience.

· Knowledge of Texas Medicaid.

· Working knowledge of CPT and ICD-10 coding, Medicaid, Medicare, and commercial payer requirements, and payer portals.

· Strong understanding of HIPAA and provider credentialing processes.

· Experience with EMR systems and improving billing or clinical workflows.

· Excellent leadership, communication, and organizational skills.


Preferred

· Experience with IMS.

· Medical billing or revenue cycle certification, such as CPB, CPC, or CRCR.

· Experience in nonprofit healthcare, pediatric audiology, speech-language pathology, or early intervention settings.

· Fluency in written and spoken Spanish and English.

$50,000-$70,000