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About the Role

The SCN Billing Specialist for Care Compass Collaborative manages billing and reimbursement for Health-Related Social Needs (HRSN) services under the NYHER 1115 Waiver, ensuring accurate and timely claim submissions and compliance with state and federal guidelines.

Responsibilities

• Prepare and submit claims for HRSN services in accordance with NYSDOH billing protocols and SCN Operations Manual
• Verify member eligibility and service authorization using Medicaid data systems and SCN IT platforms
• Track and reconcile payments, denials, and resubmissions; follow up on unpaid or underpaid claims
• Maintain accurate billing records and documentation for audit readiness
• Collaborate with Social Care Navigators, care managers, and provider agencies to resolve billing discrepancies
• Stay current on NYHER 1115 Waiver updates, billing codes, and reimbursement policies
• Participate in training sessions and stakeholder meetings to align billing practices with evolving SCN requirements
• May assume additional responsibilities, as requested.

Requirements

• High School Diploma and 2 years’ experience required or Associate’s degree in Health Administration, Accounting, or related field, preferred
• Minimum 2 years of experience in Medicaid billing, preferably in a community-based or managed care setting
• Proficiency in billing software, Medicaid portals, and electronic health record (EHR) systems
• Strong attention to detail, organizational skills, and ability to manage multiple priorities
• Excellent communication and critical thinking skills
• Working knowledge of Microsoft Office 365

Skills

• Knowledge of NYS Medicaid Managed Care billing requirements
• Familiarity with 1115 Waiver programs, HRSN services, and SCN workflows is highly desirable
• Experience with Unite Us or similar referral platforms used in SCN operations, such as MillinPro
• Understanding of social determinants of health and community-based service delivery
• Knowledge of NYS OMH, OASAS, and OPWDD or other rate-based billing is a plus

Location

• Remote
• Onsite

Work Type

• Hybrid

Experience Level

• 2 years of experience in Medicaid billing

Education Level

• High School Diploma
• Associate's degree in Health Administration, Accounting, or related field

About the Company

• Care Compass Network utilizes a hybrid work model where employees are able to work remotely from a home office or from the CCN office, a non-clinical professional office setting.