Pre-Billing Quality & Compliance Specialist

Ibero American Action League

City of Rochester (NY)

On-site

USD 60,000 - 80,000

Full time

14 days+

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Job summary

Ibero American Action League seeks a Billing Quality Specialist to conduct pre-billing quality reviews ensuring documentation accuracy, timeliness, and compliance before submission by Finance. The role supports billing integrity by identifying gaps, communicating findings to program leadership, and ensuring corrective follow‑up prior to claims release.

The position collaborates with Finance, Quality, Compliance, and program teams to uphold billing standards, OMIG expectations, and Life Plan

Qualifications

Analytical thinking and problem solving.
Accuracy in documenting and reviewing data.
Detail-oriented with focus on compliance.
Ability to communicate findings to leadership and staff.
Ability to work with diverse teams and maintain confidentiality.
Ethical conduct and professional integrity.
Strong written and verbal communication skills.

Responsibilities

Conduct pre-billing reviews to confirm services are supported for Finance review.
Identify missing or non-compliant documentation and communicate findings to leadership.
Track pre-billing issues and ensure timely correction.
Collaborate with Finance on documentation readiness and audits.
Support denial prevention by identifying trends and risks.
Perform audits of billing readiness and program compliance.
Prepare and distribute audit reports with recommendations.
Monitor Life Plan documentation for OMIG compliance.
Maintain HIPAA compliance and regulatory requirements.