Early Intervention Medical Billing & Reimbursement Specialist

DaMar Staffing; Massachusetts; On-site; USD 33,000 - 39,000; Full time

Benefits offered by this job

401(k)

401(k) matching

Dental insurance

Employee assistance program

Flexible spending account

Health insurance

Life insurance

Paid time off

Retirement plan

Job summary

Associates for Human Services, Inc. (AHS) is seeking a detail-oriented Medical Billing Specialist to support the Early Intervention billing and reimbursement functions.

The role ensures accurate billing, timely claims processing, and appropriate reimbursement from public and private payers. Ideal candidates have 2+ years in medical billing, familiarity with MassHealth, and the ability to resolve billing issues independently.

Qualifications

• Minimum of 2 years of medical billing, healthcare billing, or accounts receivable experience preferred.
• Experience with Massachusetts Early Intervention billing strongly preferred.
• Experience billing MassHealth and commercial insurance carriers highly desirable.
• Knowledge of insurance eligibility, authorizations, claim submission, payment posting, denials, appeals, and accounts receivable follow-up.
• Understanding of medical billing terminology, payer requirements, and HIPAA regulations.

Responsibilities

• Prepare, review, and submit accurate and timely claims for Early Intervention services to MassHealth, commercial insurance carriers, and other applicable payers.
• Review service documentation and billing information to ensure services are accurately captured and billed.
• Verify insurance eligibility and coverage and maintain accurate payer information.
• Obtain, track, and monitor insurance authorizations when required.
• Monitor submitted claims and follow up on unpaid, rejected, or denied claims.
• Research claim denials and billing discrepancies and complete necessary corrections, resubmissions, or appeals.
• Review Explanation of Benefits (EOBs), Electronic Remittance Advices (ERAs), and payer correspondence to identify payment and denial issues.
• Post and reconcile insurance payments and adjustments as appropriate.
• Monitor outstanding accounts receivable and proactively follow up on aging claims.
• Identify recurring billing or denial trends and work with program and administrative staff to resolve underlying issues.
• Maintain accurate billing records and supporting documentation in accordance with payer requirements and agency procedures.
• Work collaboratively with Early Intervention program staff to resolve documentation, authorization, demographic, insurance, and billing issues.
• Assist with billing reconciliations and reports to ensure that services provided are appropriately billed and reimbursed.
• Maintain knowledge of applicable Early Intervention payer requirements and changes in MassHealth and commercial insurance billing practices.
• Protect confidential client and health information and comply with HIPAA and agency confidentiality requirements.
• Assist with audits, payer inquiries, and requests for billing documentation as needed.
• Perform other billing and administrative responsibilities as assigned.

Skills

Attention to detail

Analytical thinking

Problem solving

Time management

Professional communication

Education

Associate degree in healthcare administration

High school diploma or equivalent

Tools

Microsoft Excel

Job description

Associates for Human Services, Inc. (AHS) is seeking a detail-oriented Medical Billing Specialist to support the Early Intervention billing and reimbursement functions.

The role ensures accurate billing, timely claims processing, and appropriate reimbursement from public and private payers. Ideal candidates have 2+ years in medical billing, familiarity with MassHealth, and the ability to resolve billing issues independently.