Position Summary:
The Life Skills Through Career Program Billing Coordinator is responsible for managing and submitting billing and claims for services provided under the Office of Developmental Programs (ODP) waivers in compliance with Pennsylvania Chapter 6100 regulations. This position ensures accurate documentation, proper service authorization alignment, and timely claim submissions through PROMISe, HCSIS, and other billing platforms. The role also ensures compliance with fiscal accountability standards, record-keeping, and audit preparation.
About Chestnut Hill College:
Founded by the Sisters of Saint Joseph in 1924, Chestnut Hill College is an independent, Catholic institution rooted in a strong liberal arts tradition that fosters equality through holistic education. Distinguished by its strong mission, collegial environment, and dedication to personalized instruction through a small faculty-to-student ratio, the College promotes the spiritual, academic, social, ethical, and moral development of the whole person. Located in the charming Chestnut Hill neighborhood of Northwest Philadelphia, it serves a culturally diverse student body.
Essentials Duties and Responsibilities:
- Prepare and submit claims for eligible services provided to individuals with intellectual or developmental disabilities in compliance with PA 6100 regulations.
- Verify that all services billed are:
- Authorized in the ISP,
- Delivered by qualified staff, and
- Properly documented per regulatory requirements (6100.481).
- Reconcile billing reports and resolve errors in the PROMISe system, HCSIS, or other electronic systems.
- Review service notes and time sheets to ensure completeness and accuracy before claim submission.
- Monitor claims to ensure that shared ride transportation and other services are billed equitably when multiple participants are served together, as required under 6100.481(c).
- Maintain detailed billing records and documentation to support all submitted claims, accessible for audit or review.
- Coordinate with program staff and program specialists to ensure documentation is submitted in a timely and compliant manner.
- Track reimbursements, denials, and resubmissions, and follow up on unpaid or rejected claims.
- Monitor service utilization to avoid overbilling and identify discrepancies.
- Support monthly financial reconciliation between billed services, payroll records, and service documentation.
- Assist with preparation for ODP audits, monitoring reviews, or financial compliance checks.
- Maintain knowledge of ODP bulletins, waiver amendments, and 6100 fiscal regulations and incorporate any regulatory changes into billing practices.
- Train or support other staff on documentation requirements and billing compliance processes.
Qualifications:
- Bachelor’s degree in accounting, finance, business administration, or related field.
- Minimum two (2) years of experience in medical billing, Medicaid waiver billing, or human services billing.
- Familiarity with ODP billing procedures, PROMISe system, HCSIS, and related platforms strongly preferred.
- Knowledge of 55 Pa. Code Chapter 6100, especially fiscal regulations under 6100.481–6100.489.
- Strong analytical and problem-solving skills, attention to detail, and accuracy.
- Proficient in Microsoft Excel, Word, and billing software systems.
- Strong communication skills and ability to work with multiple departments and funding sources.
Additional Requirements:
- Must complete and maintain annual training on:
- Fraud prevention
- Medicaid billing compliance
- ODP fiscal accountability standards
- Must pass required criminal background checks, including FBI fingerprinting, PA State Police clearance, and child abuse clearance.
- Adherence to confidentiality and HIPAA compliance standards.
- Ability to work independently and manage multiple tasks and deadlines.
Working Conditions:
- Office-based role with occasional travel to service locations or training.
