Early Intervention Billing Specialist

Description

 Reports To: Program Director
Employment Type: Full-Time

Position Summary

The Early Intervention Billing Specialist is responsible for ensuring the accurate and timely processing of insurance claims, managing service authorizations, and securing proper reimbursement for early intervention (EI) services. This role acts as a key bridge between clinical/program staff, families, and funding sources—including Medicaid, state early intervention programs, and private commercial insurance. 

Key Responsibilities

Claim Preparation and Submission

· Review session notes, attendance logs, and service records for accuracy and completeness before billing.

· Code and submit clean electronic or paper claims to Medicaid, state agencies, and private insurance providers.

· Ensure strict adherence to state-specific early intervention regulations, billing guidelines, and coding standards

Insurance Verification and Authorizations

· Verify patient health insurance eligibility, coverage limits, and active policy status prior to service delivery.

· Track, enter, and update service authorizations (units, frequency, and duration) in the billing software.

· Coordinate with coordinators and clinical providers to resolve missing or expired authorizations

Accounts Receivable (AR) and Denials Management

· Monitor Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs) to post payments and adjustments accurately.

· Research, correct, and resubmit rejected or denied claims promptly.

· Proactively follow up on aging accounts receivable (AR) and persistent unpaid claims.

· File formal insurance appeals when legitimate claims are underpaid or wrongfully denied

Communication and Collaboration

· Communicate professionally with families to explain insurance benefits, copays, or billing statements.

· Collaborate closely with early intervention program staff and case managers to resolve documentation, demographic, or scheduling discrepancies.

· Provide regular reports to management regarding billing metrics, revenue trends, and recurring denial patterns

Requirements

Qualifications & Skills

Education: High school diploma or equivalent required

Knowledge Base: Strong familiarity with Medicaid billing portals, commercial insurance structures, and clearinghouses

Technical Skills: Proficiency with electronic health record (EHR) / billing software and Microsoft Office

Soft Skills: Exceptional attention to detail, strong problem-solving abilities, and clear verbal and written communication skills

Compliance: Working knowledge of HIPAA guidelines and commitment to maintaining strict client confidentiality.

What we offer:

• Comprehensive benefits, including health, dental, vision, and retirement/401(k) with company matc
• Generous PTO and paid holidays
• Monday - Friday, no weekends
• A supportive and collaborative team environment