GILEAD - Medical Billing Specialist

Gilead Community Services is seeking a detail-oriented and motivated Medical Billing Specialist to join our Finance Department team. This full-time position plays a vital role in supporting our programs by ensuring accurate, timely, and compliant billing processes.

About the position

The Medical Billing Specialist is responsible for insurance verification, claim submission, payment reconciliation, accounts receivable follow-up, and maintenance of client insurance records. Working collaboratively with billing, finance, and program staff, this position helps ensure accurate and timely reimbursement for services provided while supporting the overall effectiveness of the organization's billing operations.

This is a full-time, 40-hour per week position, Monday through Friday. The standard schedule is 8:00 AM – 4:00 PM.

Key Responsibilities

Independently verify health benefits through various web based clearing houses such as CT DSS Map, Availity, and Change Healthcare.

Enters and maintains client insurance information in the electronic health record.

Apply knowledge of medical billing to generate, review and submit electronic and paper bills to insurance companies on a regular basis.

Actively works all accounts receivables for timely collection of outstanding balances.

Continuously updates prior authorizations within the electronic health record.

Process claims for billable services provided at Gilead’s various programs.

Review explanation of benefit statements and or remittance advice for denials and resubmit corrected billing as needed.

Mails client statements of account on a monthly basis.

Assists with the credentialing of billable service providers using the various web-based resources such as CAQH.

Works in coordination with the Senior Billing Administrator and the Oak Hill Finance team on intercompany billing projects including planning, implementation, and maintenance.

Qualifications

High school diploma/GED required

Three (3) years of medical billing or medical office experience required.

Medical Billing Certification preferred.

Proficiency in Microsoft Word, Excel, Outlook and medical billing software.

This is a non-union position, the pay range is $22.00 per hour - $26.00 per hour, dependent on level of education and experience.

Benefits

Generous paid vacation, sick, and personal time, plus paid holidays

Medical, Dental, and Vision Insurance

Hands-on learning experience and supervision

Scholarship, tuition reimbursement, and professional development opportunities

Paid training, education, and certification as necessary (including CPR and continuing education)

Gilead employees are held to standards and regulations set by the Department of Mental Health and Addiction Services (DMHAS) and other regulatory bodies. These standards are outlined in Gilead’s “Standards of Conduct” policy. It’s important that these standards and regulations are met through all duties performed, outcomes achieved, and conditions kept within the organization.