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SafeRide Health is seeking a Billing & Claims Specialist to support the scaling of its healthcare transportation operations as the company grows past $100M in annual revenue. This role is central to SafeRide's billing function, which processes claims for Non-Emergency Medical Transportation (NEMT) and General Medical Rides (GMR) under Medicare and Medicaid programs.
Key responsibilities include processing and facilitating data for claims submissions, reconciling billing data against encounter data, and collaborating with operations teams to resolve discrepancies. The specialist will work with internal teams and external providers to troubleshoot claims-related issues, interpret benefit plans and provider contracts, and ensure accurate payment in compliance with healthcare regulations and CMS/Medicaid guidelines. The role involves receiving and resolving incoming inquiries from providers, customers, vendors, and internal stakeholders, as well as identifying systemic issues affecting the provider community (e.g., system configuration, EDI logic, authorization rules).
The specialist will develop and implement billing policies and procedures aligned with industry best practices, serve as a subject matter expert for claims-related projects, mentor junior team members, and provide training and guidance on complex issues. Additionally, the role includes implementing scalable billing operations systems and financial reporting for management, clients, and state/federal agencies such as HHSC in Texas.
Required qualifications include a minimum of 1 year of billing/claims management experience and fluency in Spanish (bilingual requirement). Preferred experience includes NEMT/transportation background and knowledge of CMS/HHSC regulations. The ideal candidate demonstrates strong Excel/Sheets proficiency (pivot tables, v-lookups), self-motivation, problem-solving ability, and adaptability in a fast-paced environment.