Billing Analyst

Position Summary: The Billing Specialist handles insurance claim submissions, tracks prior authorizations, and investigates denied claims to ensure providers are paid accurately. The Billing Specialist will perform data entry, data integrity checks, data reporting, compliance oversight, physical and digital paperwork processing, and project management across all Behavioral Health functions and programs.

Core Competencies: Mission and Fit: Embodies Fortune's mission and fit, and will be an effective member of the team in furthering both. The candidate should exhibit compassion and understanding for our participants (wherever they are in their re-entry process) and embrace Fortune's core value that none of us should be measured against the worst things we have done. Project Management: Manage projects successfully throughout project lifecycle from inception to delivery with a results-driven mindset. Ensure data integrity through consistent monitoring, validation, and quality control. Identify errors or inconsistencies, implement corrective actions, and train staff as needed to maintain compliance with regulatory, contractual, and billing requirements. Demonstrate strong attention to detail and accountability in all data-related work and project timelines. Analytical Thinking: Effectively analyze and synthesize data from multiple internal and external systems to produce accurate, timely reports. Identify trends, risks, and performance gaps; anticipate next steps; and provide data-driven insights to support operational planning, forecasting, and contract compliance. Collaboration: Partner effectively with program leadership, EQI, IT, and clinical staff to support data analysis and reporting. Communicate complex data clearly and professionally to diverse audiences, translating findings into actionable recommendations while working in a culturally responsive and team-oriented manner.

Essential Duties and Responsibilities: Perform weekly reviews and submissions of TS/BLC clinical service billing of all locations; Stay informed on the latest billing guidelines and ways of workings announced by state & federal agencies; Perform weekly reviews and submissions of of SCN invoices in Unite Us; Review denied invoices once they are adjudicated and support Millin's appeal process; Process and submit monthly Queenboro Work Release vouchers with the latest charge rates; Perform weekly reviews and submissions of Medicaid reimbursements of OMNY cards; Perform monthly reviews and submissions of OMH CRSRO Housing billing; Work with the clinicians or SCNs to fix claim/invoice/voucher/allocation errors of all BH billing functions in a timely manner; Provide periodic information/data that is requested by finance; Assist the Data Analytics Manager with routine auditing of BH billing practices; Serve as the back-up person to facility, provider, and insurance payer credentialing paperwork preparation; Perform other duties as assigned.

Qualifications: Bachelor's degree in Business, Healthcare Administration, Finance, or related field;2+ years of medical billing/revenue cycle management, with at least 2+ years in a leadership role; Strong knowledge of ABA billing, coding, and payer requirements; Proficiency with Caseworthy, AccuMed, EHR systems, and Microsoft 365; Exceptional communication and organizational skills; Ability to work in a fast-paced, evolving environment with precision and attention to detail. We seek talented, dedicated individuals from all walks of life who possess a strong commitment to this mission. Relevant personal experience is a plus.

Physical Demands: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The responsibilities and requirements listed are representative of the knowledge, skills, minimum education, training, licensing, experience, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job. The Fortune Society is an Equal Opportunity Employer. All qualified applicants will be afforded equal employment opportunities without discrimination because of conviction history, race, religion/creed, color, national origin, sex, age, disability, sexual orientation, gender identity, military status, predisposing genetic characteristics, victim of domestic violence status or marital status.