Billing & Claims Specialist - Bilingual (Spanish)

Responsibilities

• Facilitates data processing and processes claims for NEMT and GMR rides.
• Performs reconciliation of billing data to encounter data.
• Works closely with the operations team to resolve issues.
• Works with internal operations and project teams to solve claims-related problems, benefit plans research, and provider contract interpretation and configurations.
• Communicates and works with providers to get claims issues resolved and paid accurately and in accordance with healthcare/Medicare/Medicaid regulations, policies, and payment policies and guidelines.
• Receives incoming calls from providers, customers, vendors, and internal groups, analyzes the caller's needs, researches information, answers questions, and resolves issues and/or disputes in a timely and accurate manner.
• Identifies issues negatively impacting the provider community, including but not limited to system setup, required benefit modifications, EDI logic, provider education, claim examiner errors, and authorization rules.
• Develops and implements policies, processes, and procedures that incorporate industry best practices and reinforce high quality standards within the Billing team.
• Serves as the Billing team’s subject matter expert and primary contact for claims-related projects and critical activities.
• Mentors junior team members and provides internal claims team training, coaching, guidance, and assistance with complex issues.
• Implements scalable and accurate billing operations systems leveraging best-in-class technology, including financial reporting for management, clients, and designated state and federal agencies (e.g., HHSC in Texas).
• Champions and reinforces SafeRide’s culture.

Requirements

• Minimum 1 years of experience in billing/claims management.
• Must be bilingual Spanish Speaking.
• PREFERRED: NEMT/transportation background.
• PREFERRED: Knowledge of CMS/HHSC regulations.

Skills

• Strong data skills in Excel/Sheets, including pivot tables, v-lookups, etc.
• Self-starter, ability to work independently and in a team environment.
• Strength in problem-solving, applying hard data and qualitative insight to frame problems and develop novel solutions.
• Ability to adapt to unforeseen circumstances quickly.
• Keen attention to detail.
• Ability to work with a variety of stakeholders.

About SafeRide Health

SafeRide’s mission is to restore access and dignity to care. SafeRide is transforming access to care for the nation’s sick, poor, and underserved. We are a high-growth, tech-enabled services firm that’s growing past 400 employees. SafeRide is backed by premier investors like NEA and serves clients like Fresenius. We operate nationally and now deliver over 5 million rides per year. Learn more at www.saferidehealth.com.