Billing & Data Coordinator

Billing & Data Coordinator

The Billing & Data Coordinator ensures accurate, timely, and compliant billing and data management for Wraparound services. This role supports the agency's administrative accountability, data integrity, and audit readiness by preparing, submitting, reconciling, and auditing claims in accordance with the Louisiana Medicaid Behavioral Health Services Provider Manual, the 1915(c) HCBS Waiver, Magellan requirements, and internal quality standards. The position is also responsible for the complete and accurate collection, validation, and submission of member-level and program data required under the Louisiana Coordinated System of Care and The Wraparound Model. Working collaboratively with the Wraparound Quality & Assurance Specialist, the Wraparound Billing & Data Coordinator maintains data integrity across WAA information systems, supports dashboards and performance monitoring, and contributes to fidelity, outcome tracking, and responsive care coordination. The Wraparound Billing & Data Coordinator reports to the Director of Wraparound Services.

Exempt/Full Time

Essential Functions

• Prepare, verify, and submit electronic claims for Wraparound services ensuring coding, units, and service dates meet Medicaid and Magellan rules and documentation standards meet Magellan and Medicaid rules and documentation standards.
• Monitor payer acknowledgements; resolve front-end declinations and payer edits within established timelines.
• Ensure all billing aligns with the Louisiana Medicaid Behavioral Health Services Provider Manual and applicable 1915(c) waiver provisions, including service authorization.
• Research and correct denials; prepare and submit timely appeals with supporting documentation.
• Work with myEvolv billing staff to Post remittances (EOB/ERA), reconcile payments, identify underpayments/overpayments, and coordinate refunds and re-bill as necessary.
• Collaborate with the Wraparound Quality & Assurance Specialist to validate member-level data elements that meet Magellan and LDH reporting requirements.
• Generate dashboard submissions as determined by program management (weekly, biweekly, monthly); support continuous quality improvement and corrective action plans.
• Communicate professionally with Magellan, LDH, and other stakeholders on claim status and documentation needs; respond to payer inquiries within required timeframes.
• Assist with staff training on documentation-to-bill workflows, including common denial reasons and prevention measures.
• Support internal/external audits and help implement remediation items from the reviews.
• Monitor error queues, resolve discrepancies, and ensure data align to Magellan/LDH specifications and internal data dictionaries.
• Provide direct supervision and guidance to assigned administrative staff, including onboarding, training, coaching, and performance feedback.
• Review and approve employee timecards, leave requests, and schedule adjustments in accordance with agency policy and labor requirements.
• Address workflow issues, resolve staff concerns, and escalate personnel matters as appropriate.

Competencies

1. Proficient in Microsoft 365 (Word, Excel, Outlook)

Supervisory Responsibility

The Billing & Data Coordinator supervises the Administrative Assistant I and the Administrative Assistants.

Required Education and Experience

• Master's degree in business administration, health administration, or related fields.
• Experience with electronic claim submissions, remittance posting, and denial management, and appeals.
• Prior experience with billing wraparound claims.
• Two (2+) years of experience working with a CSoC program, including experience with the myEvolv EHR System, and the SFTP Magellan Network.
• Five (5+) years of supervisory experience.
• Experience with handling Protected Health Information (PHI), Medicaid/Managed Care documentation, or behavioral health programs.

Other Requirements

• Must maintain a valid Louisiana driver's license

Physical Demands

While performing the duties of this job, the employee is frequently required to stand; walk; sit, use hands, handle, or feel objects, tools or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus. While performing the duties of this job, the employee can sometimes be exposed to weather conditions. The noise level in the work environment is usually moderate.

Other Duties

• Participate in training and development activities as required.
• Collaborate with The Quality & Assurance Specialist to conduct internal and external audits. Working knowledge of electronic health records, behavioral health billing, Medicaid rules, and HCBS waiver concepts; ability to interpret payer policies and apply them to day-to-day workflows.
• Perform all other duties as assigned

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Volunteers of America South Central Louisiana, Inc. offers a comprehensive benefit package to include: Health, Dental, and Vision Insurance, 403-B Pension Plan, Short and Long Term Disability Insurances, Life Insurance, paid annual holidays, Vacation and Sick leave.

Equal Opportunity and Affirmative Action employer, Volunteers of America South Central Louisiana, Inc. considers applicants for all positions without regard to race, color, religion, creed, gender, national origin, age, disability, marital or veteran status, or any legally protected status. We will make reasonable accommodations for qualified individuals with known disabilities unless doing so would result in an undue hardship.