Billing Specialist & Project Analyst

The Billing Specialist & Project Analyst manages the healthcare (Medicaid) revenue cycle by translating services performed by Community Living of Rhode Island into appropriate billing codes, submitting claims to BHDDH through Gainwell Technologies, processing payments, reconciling accounts, and resolving claim denials. This role also supports project planning and analysis by monitoring, evaluating, and reporting on projects to ensure alignment with goals, budgets, and timelines.

Key responsibilities include: translating services into Medicaid billing codes, submitting claims, processing payments using Explanation of Benefits (EOBs) and Remittance Advice (RA), reconciling accounts, researching claim denials, maintaining HIPAA compliance, communicating with coordinators and payers, supporting project lifecycle monitoring, data analysis, reporting, maintaining project documentation, and tracking KPIs for operational improvements.

Required qualifications: experience in healthcare or Medicaid billing and revenue cycle management, knowledge of medical terminology and ICD-10 coding, strong analytical and organizational skills, communication skills, multitasking ability, and proficiency with project management and data tracking tools.

Preferred qualifications: experience with BHDDH and Gainwell Technologies, background in developmental disabilities or behavioral health, and an Associate’s or Bachelor’s degree in Healthcare Administration, Business, Finance, or related fields.

Skills include revenue cycle management, data analysis, HIPAA compliance, project documentation, time management, and stakeholder communication.

Benefits: 401(k), dental insurance, health insurance, paid sick time, paid time off, employee discount, life insurance, vision insurance, and opportunities for advancement.

Work location: In person.