Billing Specialist

Company Description

MEET MAE

Mae is a venture-backed digital health solution on a mission to improve the health and quality of life for mothers, babies, and those who love them. Mae has created a space where complete digital care meets culturally-competent on-the-ground support. We address access gaps and bolster physical and emotional well-being through continuous engagement, risk assessment, early symptom awareness, and a community-led model of support for our users.

Digital solutions to address cultural deficits in care are at the forefront of femtech innovation and Mae is quickly gaining traction with healthcare payers as a viable solution to address the implicit, explicit, and structural biases that hinder equitable maternal health. In addressing whole-person care and focusing on self-advocacy, education, and community, we seek to improve the outcomes for mothers and birthing people, while also reducing clinical costs of care, at impactful scale. See what we're doing at www.meetmae.com and @maehealthinc on Instagram.

At Mae, we are :

• Solution-Oriented . We make every problem an opportunity to improve.
• Curious. We demonstrate focused curiosity.
• Mission-connected. We ensure mamas and doulas are heard.
• Adaptable . We learn, adapt, and execute.
• Data-driven . We quantify the uncertainty.
• Accountable . We own our decisions and their outcomes.
• Transparent . We don't hide the hard stuff.

Job Description

As a billing specialist, you will ensure claims are submitted promptly and accurately to the appropriate payer, with the majority of these being Medicaid Managed Care Organizations (MCOs). The billing specialist will liaise with Mae Health's program managers and health plan Electronic Data Interchange (EDI) / billing points-of-contact to identify and troubleshoot issues with claims submission and / or payment.

Key Responsibilities Include :

Review claims prior to submission for coding accuracy, appropriate rate assignments, and completeness to ensure high standards of "clean claim" submissions, utilizing Candid Health's RCM ("Candid") platform

Resolves claim errors and / or discrepancies and expediently communicates any issues to plan EDI point-of-contact and relevant Mae personnel

Monitors and tracks claim payments in Candid and flag for provider direct-payment accordingly

Preparing reports for Mae's Executive Leadership Team on claims trends, performance against SLAs, and identifying issues or concerns with claims adjudication that require further escalation

Meticulous record-keeping of claim submissions, status, and pertinent notes to keep internal stakeholders informed

Providing technical assistance and ongoing training support to fellow team members

Qualifications

What we are looking for in candidates :

Additional Information

All your information will be kept confidential according to EEO guidelines.

We are currently only hiring US based applicants and are unable to sponsor visas.

Mae Health Participates in E-Verify

This employer participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. If E-Verify cannot confirm that you are authorized to work, this employer is required to give you written instructions and an opportunity to contact Department of Homeland Security (DHS) or Social Security Administration (SSA) so you can begin to resolve the issue before the employer can take any action against you, including terminating your employment. Employers can only use E-Verify once you have accepted a job offer and completed the Form I-9.