Billing Specialist

Position Title: Billing Specialist

Reports To: Director of Finance
FLSA Status: Full-Time, Non-Exempt

Works Closely With: Program Directors, Clinical/Operations Teams, Finance Department

Organization Overview

Over twenty years ago, our founders created a different kind of human services agency: one that provides high-quality services to historically disadvantaged communities of color, while also advocating for the rights of people with disabilities. They were frustrated with the lack of leadership and career opportunities for Blacks, Indigenous, People of Color (BIPOC). Even though many human services professionals are people of color, few are in leadership and change-making roles. Our founders took the bold step of creating a new agency.

Today, we are the largest minority-led human service agency in Massachusetts, our leadership team and Board are predominantly comprised of people of color. We provide in-home care and support to seniors and individuals with developmental disabilities in the Boston, Brockton, and Springfield areas.

Our core belief is that “people are greater than their disabilities”, and all our services reflect this belief.

Position Summary

The Billing Specialist is responsible for the accurate, timely, and compliant billing and collection of program revenues across AFC, ABI/MRC, and Transitional Assistance programs. This role oversees the daily operations of the billing function, ensures claims are properly submitted, actively analyzes denials and aging A/R, and takes corrective action to protect cash flow. The Billing Specialist plays a critical role in ensuring billing integrity, audit readiness, and alignment with MassHealth, Medicaid, and other payer requirements.

Key Duties and Responsibilities

Billing Operations & Oversight

• Lead and coordinate all aspects of the billing function for AFC, ABI/MRC, and TA programs.
• Ensure timely and accurate submission of claims in accordance with payer rules, MassHealth regulations, and VHS policies.
• Oversee month-end closing of billing systems, ensuring all charges, adjustments, refunds, write-offs, and payment postings are completed accurately and on schedule.
• Maintain complete, accurate, and audit-ready billing and accounts with receivable records.

Denials Management & Rebilling

• Analyze denied, rejected, and suspended claims to identify root causes (authorization, eligibility, documentation, coding, payer error, etc.).
• Research payer requirements and regulations to determine appropriate corrective actions.
• Rebill, appeal, or correct claims as necessary to maximize reimbursement and minimize revenue loss.
• Track denial trends and work collaboratively with program, clinical, and operations teams to prevent recurring issues.

Accounts Receivable & Aging Analysis

• Actively analyze A/R aging reports, including 30/60/90-day balances, to identify risks and prioritize follow-up actions.
• Investigate delayed or unpaid claims and escalate issues appropriately with payers, internal teams, or leadership.
• Develop and monitor billing KPIs such as days in A/R, denial rates, clean claim rates, and cash collections.

Compliance & Controls

• Ensure billing practices remain compliant with MassHealth, Medicaid, Medicare (if applicable), and other payer requirements.
• Support audits, reviews, and regulatory inquiries by maintaining strong documentation and internal controls.
• Identify process gaps and recommend improvements to strengthen billing accuracy and compliance.

Collaboration & Communication

• Work closely with Program Directors, clinical staff, and operations teams to ensure documentation, authorizations, and service data are complete and timely.
• Alert appropriate stakeholders regarding missing or late documentation impacting billing.
• Establish and maintain positive working relationships with payers, internal teams, and external partners.

Staff Leadership & Development

• Supervise, train, and mentor billing staff on billing systems, payer requirements, workflows, and best practices.
• Manage daily workflow, workload prioritization, and performance expectations aligned with departmental goals.
• Provide ongoing coaching, feedback, and performance evaluations.

Additional Responsibilities

• Attend meetings as required.
• Maintain confidentiality of patient and organizational information in compliance with HIPAA and Victory Human Services policies.
• Perform other related duties as assigned to support the finance and operational functions.

Qualifications & Requirements

• Certificate or degree in Medical Billing, Coding, Accounting, or related field preferred.
• 2–5 years of billing experience, with AFC billing experience strongly preferred; experience with ABI/MRC and TA billing plus.
• Strong working knowledge of MassHealth, Medicaid, and managed billing processes.
• Prior supervisory or lead experience in a billing or business office environment preferred.
• Proficiency in Excel, Word, and billing systems; ability to analyze reports and billing data effectively.
• Ability to read, analyze, and interpret complex payer regulations and policy documents.
• Strong organizational skills with the ability to manage multiple priorities and deadlines.

Compensation & Benefits

• Comprehensive health and dental insurance
• Retirement plan with organizational contribution
• Generous paid time off and holiday schedule
• Professional development and continuing education support
• Opportunity to make a meaningful impact in underserved communities

Join Our Mission

At Victory Human Services, you’ll join a team dedicated to advancing equity and inclusion in human services across Massachusetts. If you’re ready to bring your administrative excellence and passion for people to an organization that makes a measurable difference, we encourage you to apply.

Please send a copy of your resume and cover to: [email protected]

Benefits Offered:

BCBS Medical, Dental, Vision

TASC - Flexible Spending Account and Dependent Care

Sick

Vacation

Employee Assistant Program

Tuition Reimbursement

Submit your resume now for consideration!

Victory Human Services is an Equal Opportunity Employer. We do not discriminate against race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, or genetic information.

Job Type: Full-time

Pay: $50,000.00 - $60,000.00 per year

Work Location: Hybrid remote in Brockton, MA 02301