Billing Quality Specialist

Job overview

The Billing Quality Specialist role is onsite in Rochester, NY. Compensation is not specified. The position works under the Senior Director of Quality & Performance and supports billing integrity and HCBS Life Plan compliance at Ibero-American Action League. The specialist reviews documentation before billing, identifies gaps and compliance risks, and coordinates corrective follow-up with program leadership and Finance. Audit reporting and trend analysis help prevent denials and strengthen documentation and quality processes; Finance remains responsible for final claim submission.

What you'll do

• Conduct pre-billing documentation reviews
• identify missing, incomplete, inconsistent, or non-compliant records
• communicate findings and track resolution within billing timelines
• collaborate with Finance on documentation readiness and audit findings
• identify denial risks and workflow gaps
• perform quality and compliance sampling audits
• prepare audit reports
• track trends and training needs
• review and monitor HCBS Life Plan documentation and processes
• support related policies, procedures, and quality tools
• maintain HIPAA compliance.

What we're looking for

Skills & competencies

billing quality specialist

ibero-american action league

rochester ny

full-time

pre-billing review

billing integrity

denial prevention

hcbs life plan

omig compliance

hipaa

quality audits

documentation review

medicaid services

Work arrangement

• Weekend coverage required

Why this role

Supports HCBS Life Plan compliance and pre-billing denial prevention; bilingual English and Spanish skills are preferred.

About the employer

Ibero-American Action League, Inc. is hiring for this role. Industry: Other Individual and Family Services. Sector: 62.