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8 days ago
Requirements and responsibilities
Role OverviewAs Hey Jane expands to partner with more payers, we are seeking a highly organized and detail-oriented Billing Specialist with specific expertise in Medicaid. You are someone who thrives in dynamic environments and is motivated by the opportunity to help more patients access care with fewer out-of-pocket costs.In this role, you will manage the smooth and efficient handling of billing operations, ensuring our workflows and claims remain in strict accordance with coding standards. You will act as a crucial bridge between our Clinical and Clinical Operations teams and our third-party billing partner. From accurately processing claims to resolving complex billing issues and maintaining compliance, you will ensure that the intricacies of insurance reimbursement never slow down our mission.The ideal candidate has a strong background in medical billing and coding and possesses the analytical skills to navigate the nuances of state-funded programs. You excel at spotting gaps, creating structure where it’s needed, and being persistent in communications to ensure our clinicians can focus on patients rather than administrative hurdles.Why this role mattersThis isn’t your average administrative role: the systems you maintain and improve directly determine how quickly and effectively patients can access safe, timely, and compassionate care. By mastering the complexities of Medicaid, you are personally expanding healthcare equity and ensuring that financial barriers don't stand in the way of essential services. In a moment where access to care is more important than ever, your work will have a tangible impact on the future of accessible healthcare across the U.S.Responsibilities Ensure a smooth, efficient, and timely claim submission process with minimal denials, including identifying gaps in claimsFollow up on unpaid claims, denials, and appeals to ensure maximum reimbursementInvestigate and resolve billing discrepancies or coding issues Collaborate with internal teams, including clinicians, to provide charting requirements and necessary documentation for claims submission, training team members on billing processes, and creating workflows for billing operationsProvide support and guidance to patients regarding their insurance coverage, financial assistance, and billing inquiriesManage abortion fund invoicing and reimbursementsMaintain accurate and organized billing records and documentationGenerate and analyze reports to monitor billing performance and identify areas for improvementSupport new payor partnerships, working collaboratively with internal and external stakeholders to own billing and coding workflows as we growMaintain knowledge of current billing and coding regulations and updatesStay up-to-date with changes in insurance policies, fee schedules, and reimbursement ratesAssist with other billing-related tasks as neededRequirements2+ years experience as a Billing Specialist in a healthcare setting (preferably in a telehealth setting)Deep expertise in Medicaid billing guidelines, including familiarity with state-specific reimbursement rules and eligibility verificationStrong proficiency in ICD-10, CPT, and HCPCS coding, particularly as they relate to abortion services and sexual and reproductive healthProven experience managing the full claims lifecycle, including submission, denial management, and appealsHands-on experience with Electronic Health Records (EHR) and Revenue Cycle Management (RCM) systemsSolid understanding of HIPAA regulations and a strict commitment to maintaining patient data privacyStrong attention to detail and accuracyAbility to effectively communicate with patients, insurance companies, and internal stakeholdersProficient in using Excel or Google SheetsAbility to work independently in a fast-paced environmentStrong organizational and time management skillsPassion for advancing equitable healthcare, with a deep-rooted ability to empathize with Hey Jane patientsDetailsCompensation: $65-72k + equityRemote from approved states (CA, CO, IL, MA, MD, NJ, NY, OR, and WA) with preference in NYCUnlimited vacationHealth, dental, and vision insurance with FSA