Billing & Claims Specialist

The Billing and Claims Specialist supports financial operations related to billing and claims processing across all program services. This role is responsible for maintaining accuracy in state and insurance billing systems reconciling claims activity monitoring rejected or denied claims and preparing financial documentation to support internal reporting and audit readiness. Accurately applies and reconciles payments received for services.

This is a highly detail-oriented role that requires technical proficiency with billing software (Cashe Pavillio MN-ITS) strong analytical skills and the ability to manage multiple priorities while ensuring timely follow-up on claim rejections

Position Title: Billing & Claims Specialist

Department: Finance

Hours: Full-time 40 hours/week Monday Friday (non-exempt)

Location: Lifeworks Services Richfield / 20% in-person

Compensation: $26 - $30 per hour

Bonus Eligible: Yearly

What we offer employees

Lifeworks offers a comprehensive benefits package which includes:

• 18 days of PTO accrued in the first year of employment
• 11 paid holidays (New Years Day Martin Luther King Jr. Day Memorial Day Juneteenth Independence Day Labor Day Thanksgiving Day after Thanksgiving Christmas Eve Christmas Day and a Personal Holiday)
• Medical dental vision life AD&D insurance short & long-term disability coverage
• Health Savings Account (HSA) Flexible Savings Account (FSA) and prescription drug coverage
• Up to $3000 annually in tuition reimbursement
• 403(b) retirement plan Lifeworks contributes 3% of your salary and matches up to 4% of employee contributions
• Employee Assistance Program (EAP)

Why Work at Lifeworks

Lifeworks is an industry leader on the forward edge of partnering with people with disabilities in innovative person-centered ways. Disability inclusion is our true north guiding every service we provide and ensuring that people with disabilities have opportunities can thrive and defy expectations. The Lifeworks Team is collaborative passionate and strategic using a person-centered approach to increase access in our communities.

Youll succeed in this role if you:

• Have excellent organizational skills. Must be able to manage multiple tasks and prioritize claims and payments efficiently.
• Possess strong analytical skills to research claim denials and identify root causes of errors.
• Have a deep understanding of medical coding medical claims processing systems and claims processing protocols.
• Understand and communicate written and verbal directions.
• Are reliable punctual and have regular attendance necessary to meet the needs of the business.
• Are well organized with excellent attention to detail.
• Work independently with excellent time management skills.
• Work effectively with others to reach common goals and objectives.
• Can establish and cultivate strong relationships.
• Take initiative and strengthen relationships with current and new community.
• Must pass a background study with the Department of Human Services a drug test clean driving record and have reliable transportation to use for work driving purposes (e.g. in-office on-site training locations etc.).

How youll be spending your time:

• Submitting accurate and timely billing for a variety of services through multiple billing system.
• Processing and submitting Medical Assistance and insurance claims.
• Confirming acceptance of claims.
• Handling state and insurance billing cycles including claim replacement.
• Entering and billing for employer-related adjustments (e.g. SUTA and FICA true-ups).
• Creating invoices for unit-based and dollar-based overspending.
• Uploading program-specific recurring expenses.
• Monitoring billing activity and resolving issues to ensure reimbursement accuracy and compliance.
• Regularly reviewing rejected eligibility and billing batches (daily/bi-weekly).
• Monitoring shared billing inboxes (e.g. ).
• Coordinating and processing claim rebills based on rejection trends.
• Maintaining and updating the Rejection Spreadsheet; prioritize items for follow-up.
• Researching denied claims (e.g. N362 exceeded units) and applying corrective actions.
• Adding notes and resolution steps to denied claims and track status of rebills.
• Supporting fiscal integrity by reconciling billing and payment activity preparing financial reports and tracking claim outcomes.
• Adding state billing totals to internal cash spreadsheets.
• Running and analyzing aged reports and preparing the Over 90s report for leadership.
• Researching aging balances and making recommendations for adjustments or write-offs.
• Applying approved revenue adjustments and uncompensated care write-offs.
• Maintaining accurate billing logs and documenting across systems.
• Accurately applying payment as received.
• Invoicing for client responsibility.
• Remaining current on all relevant program service rules and requirements as it relates to service billing.
• Adhering to obligations under HIPAA and Generally Accepted Accounting Principles (GAAP).
• Following safety procedures and assisting in identifying safety needs for self and others.
• Perform other duties as assigned.

• 5 years of medical claims billing experience and High School Diploma/GED.
• Associate degree in healthcare administration accounting or business preferred.
• Experience billing through electronic health records (EHR) or other medical billing software systems.
• Proficiency in Microsoft Office Suite with intermediate to advanced skills in Excel.
• Fluent in English verbal and written.

Equity Statement:

Lifeworks strives to be radically accessible diverse equitable and inclusive. We appreciate the vibrancy of differences center the voices of silenced and marginalized people and champion universal rights.

Lifeworks Services is committed to hiring people from a variety of diverse cultures with diverse life experiences. All qualified applicants will receive consideration for employment without regard to race color religion sex age national origin protected veteran status disability status sexual orientation gender identity or expression marital status familial status; genetic information or any other characteristic protected by law.

Lifeworks Services is an equal opportunity employer and we encourage members of diverse groups to apply.