Public Partnerships | PPL

Role Description The Senior Director of Clinical Operations, Home Care leads the oversight of annual health assessment screenings and clinical documentation for the NY CDPAP program. This role is responsible for supervising a team of RNs reviewing vendor-provided assessments and personal assistant documentation to ensure compliance with regulatory standards and internal quality guidelines. The position plays a critical role in clinical quality assurance, staff development, and process improvement, while collaborating cross-functionally to support efficient, compliant operations. Key Responsibilities - Annual Health Assessments - Oversee pre-employment health screenings for all new NY CDPAP Personal Assistants (PAs) in partnership with vendors contracted to perform clinical evaluations. - Oversee annual health screenings for all existing NY CDPAP PAs in partnership with vendors and internal teams. - Ensure assessments are completed accurately and within required timelines. - Assist in escalated medical record reviews when health screening results are unclear or challenged by PAs. - Review medical histories, functional status, and identified health concerns. - Maintain compliance with state, federal, and agency requirements related to home care assessments. - Prepare documentation for audits, surveys, and quality reviews as needed. - Compliance & Quality Assurance - Maintain up-to-date knowledge of home care regulations, Medicaid and managed care requirements, and agency policies. - Ensure adherence to HIPAA confidentiality standards and internal protocols. - Track assessment due dates and documentation requirements to ensure ongoing regulatory compliance. - Support the development and updating of clinical policies and procedures. - Report incidents, concerns, or significant client changes in accordance with agency protocol. Qualifications - Bachelor’s degree in Nursing (BSN) required; Master’s degree preferred. - Current, active RN license in good standing in the state of New York. - Minimum of 5 years of nursing experience required. - Minimum of 2 years of supervisory, leadership, case management, quality assurance, or care coordination experience preferred. - Prior experience in home care, community health, managed care, long-term care, or population health strongly preferred. - Demonstrated experience with clinical documentation review, regulatory compliance, and quality improvement initiatives. Requirements - Experience supervising or supporting direct care staff. - Familiarity with Medicaid, managed care, or long-term care programs. - Strong attention to detail and problem-solving abilities. - Compassionate and client-centered approach to care. Benefits - 401k Retirement Plan. - Medical, Dental and Vision insurance on first day of employment. - Generous Paid Time Off. - Employee Assistance Program and more. Compensation Range $148,000 - $166,500 annually. This role is eligible for a base salary within the posted range. Actual compensation will be determined based on a variety of factors, including skills, experience, and geographic location. Compensation may vary for positions based in high cost-of-labor markets.

Role Description It's fun to work in a company where people truly BELIEVE in what they're doing! We're committed to bringing passion and customer focus to the business. Public Partnerships LLC supports individuals with disabilities or chronic illnesses and aging adults, to remain in their homes and communities and “self” direct their own long-term home care. Our role as the nation’s largest and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and services within their state-approved personalized budget. Our culture attracts and rewards people who are results-oriented and strive to exceed customer expectations. We desire motivated candidates who are excited to join our fast-paced, entrepreneurial environment, and who want to make a difference in helping transform the lives of the consumers we serve. Duties & Responsibilities - Populates management reports and dashboards. - Compiles data and prepares reports for weekly disbursement to management. - Creates and maintains ad hoc reporting as assigned. - Develops schedules to meet deliverable deadlines for all assignments. - Records and maintains staffing data. - Maintains and updates relevant information of all agents, including extensions, schedules, programs, etc. - Prepares performance/production stack rankings of staff based on specific key performance indicators. - Creates tools on an ad hoc basis that provide insight into agent productivity as assigned. - Collaborates with management on means of improving efficiency. Qualifications - High school diploma or equivalent required; Bachelor's degree preferred. - 1-2 years’ experience in payroll and accounts payable operations or finance, preferably in an automated system environment. Requirements - Excellent accuracy and attention to detail. - Ability to work independently and as part of a team in a fast-paced environment with multiple deadlines. - Excellent written and oral communication skills. - Process-improvement oriented. - Excellent spreadsheet skills. - Strong Microsoft Office applications skills (preferably with Excel, Word, PowerPoint, and Access). Compensation Range $20-22 hourly Benefits PPL is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PPL, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PPL will not tolerate discrimination or harassment based on any of these characteristics. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!

• Supports programs in Oregon by managing relationships with state agencies and stakeholders. • Oversees contractual obligations. • Drives operational performance and business development initiatives. • Collaborates across teams for high-quality service delivery. • Identifies opportunities for growth and improvement.

Role Description The Senior Director, Revenue Cycle provides strategic and operational leadership for a centralized enrollment, authorization, eligibility, billing, and reimbursement function. A proven change agent, this leader drives organizational transformation, challenges the status quo, and builds scalable solutions across the revenue cycle — including end-to-end clearinghouse management and EDI transaction optimization. This role ensures optimal net revenue performance, efficient operations, and compliance with regulatory requirements while supporting the organization's mission, vision, and values. The position partners with senior leadership to define performance standards, translate business strategies into execution, and lead high-performing teams to deliver strong financial and operational outcomes in a complex, fast-paced healthcare environment. Duties and Responsibilities - Strategic Leadership & Business Alignment - Provides revenue cycle management leadership for centralized enrollment, authorization, eligibility, and reimbursement operations. - Develops and translates business strategies into standard technology platform product offerings and roadmaps aligned with strategic financial goals. - Responsible for the overall strategy and delivery of revenue cycle solutions. - Assesses and responds to current and future internal and external healthcare trends to guide revenue cycle direction. - Partners with senior leaders to establish operational performance standards and ensure expectations are consistently met or exceeded. - Financial Performance & Revenue Optimization - Ensures optimal net revenue and minimum invested capital through: - Integrity of authorizations and eligibility - Strong billing policies - Effective accounts receivable procedures - Denials management and prevention - Payer contract management - Collaborates on contract terms to mitigate risk and maximize financial objectives. - Drives efficient revenue cycle operations to generate optimal cash flow supporting organizational initiatives. - Operational Excellence & Execution - Directs, manages, and implements revenue cycle programs and strategies across onboarding and implementation. - Ensures efficient end-to-end operations across enrollment, eligibility, billing, and reimbursement processes. - Establishes metrics, KPIs, dashboards, and reporting to monitor: - Staff productivity - Authorization and eligibility accuracy - Enrollment files - Billing activity - Accounts receivable performance - Manages and optimizes clearinghouse relationships (e.g., Waystar, Change Healthcare) to ensure accurate and timely claim submission, remittance processing, and EDI transaction integrity (837/835/271/270). - Monitors clearinghouse edit and rejection rates and leads corrective action to minimize claim rework, submission delays, and remittance reconciliation errors. - Serves as subject matter expert (SME) for RFP content to ensure accuracy and technical rigor in authorizations, eligibility, and reimbursement. - People Leadership & Talent Development - Hires, develops, mentors, and leads a high-performing billing and reimbursement team. - Builds organizational capability to support growth and long-term success. - Holds staff accountable for achieving performance targets and business plans. - Creates a collaborative, high-performance work environment focused on service excellence. - May supervise up to 40 employees. - Collaboration & Stakeholder Engagement - Works effectively with all levels of management to influence outcomes and lead change. - Collaborates cross-functionally to align operational execution with business strategy. - Partners internally and externally to ensure the best interest of the organization in contract and operational decisions. - Acts as a change agent, championing organizational transformation initiatives that streamline revenue cycle operations, eliminate inefficiencies, and build a culture of continuous improvement and accountability. - Compliance & Risk Management - Ensures full compliance with all Federal and State regulations related to billing procedures. - Maintains integrity and accuracy of authorization, eligibility, and reimbursement processes. - Identifies and mitigates business risks through operational and contractual controls. - Analytics, Reporting & Continuous Improvement - Applies advanced analytical and problem-solving skills to drive process improvements. - Leverages data insights to influence decision-making and improve operational effectiveness. - Establishes performance tracking systems and continuous improvement initiatives. Qualifications - Bachelor’s Degree in business finance or related field. Substantial professional experience may be considered in lieu of a formal degree. - 15+ years in finance or revenue cycle management, including demonstrated experience with EDI claims processing, healthcare clearinghouse management (e.g., Waystar, Change Healthcare), and authorization management. - Proven history of leading organizational change and process transformation initiatives at scale. Requirements - Ability to work effectively with all levels of management. - Advanced analytical and problem-solving skills. - Ability to influence change and lead teams through process improvement. - Strong knowledge of billing policies, accounts receivable procedures, denials management and prevention as well as payer contract management. - Ability to work independently and as part of a team in a fast-paced environment with multiple deadlines. - Excellent written and oral communication and presentation skills. - Ability to successfully develop and lead high performing teams. - Solid technical skills to include Microsoft Office Suite applications with demonstrated Word, Excel, Access and PowerPoint expertise. - Demonstrated experience managing healthcare clearinghouse platforms (e.g., Waystar, Change Healthcare, Availity), including EDI 837/835/271/270 transaction management, error resolution, and vendor optimization. - Proven track record as a change agent with the ability to design and lead transformational initiatives, build organizational buy-in, and sustain measurable improvement in complex, matrixed environments. Working Conditions - Remote with occasional business travel. Supervisory Responsibility - May supervise up to 40 people. Compensation & Benefits - 401k Retirement Plan - Medical, Dental and Vision insurance on first day of employment - Generous Paid Time Off - Employee Assistance Program and more - Compensation range: $165,000 - $190,000 annually

Role Description The Authorization, Eligibility & Payment Integrity Analyst will support operational functions across authorization management, eligibility review, enrollment processing, timesheet pend management, CRM administration, reporting, and cross-functional process improvement initiatives. The position provides exposure to PPL’s operational lifecycle and collaboration across multiple functional areas. Duties & Responsibilities - Authorization, Eligibility, Enrollment & Payment Integrity Operations - Support day-to-day Authorization, Eligibility, Enrollment, and Payment Integrity operations across the PPL portfolio. - Obtain approved authorizations for services to be paid in accordance with payer requirements and State program rules. - Ensure authorizations, eligibility files, and enrollment records are processed and maintained in alignment with company policies, client requirements, and program protocols. - Build working knowledge of PPL operating systems, program rules, payer requirements, and operational processes. - Issue Resolution & Case Management - Assist in identifying, researching, and resolving pending timesheet, authorization, eligibility, and enrollment issues in accordance with operational procedures and program requirements. - Create, document, track, and manage CRM cases to support operational workflows, issue resolution, and administrative functions. - Respond to inquiries through CRM, system tools, and email in a professional, timely, and service-oriented manner. - Data Integrity, Compliance & Documentation - Assist with the maintenance, integrity, and accuracy of authorization records and supporting operational documentation. - Maintain and update reporting tools, operational trackers, and audit documentation to support compliance and operational oversight. - Maintain records in accordance with audit, compliance, and internal control requirements. - Analytics, Reporting & Process Improvement - Utilize analytical and data research skills to identify trends, investigate issues, and support operational process improvements. - Assist in preparing written reports, process documentation, operational summaries, and internal presentations. - Collaboration & Stakeholder Engagement - Participate in internal and external meetings related to Authorization, Eligibility, Enrollment, and Payment Integrity operations. - Collaborate with cross-functional teams to support operational initiatives, issue resolution, and workflow improvements. - Administrative & Operational Support - Route mail, email, and administrative tasks as assigned to support efficient department operations. - Support assigned operational projects and deliverables as directed by leadership. Qualifications - Bachelor's degree (completed or in progress) in any field of study. Recent graduates are encouraged to apply. - Prior internship, coursework, or project experience involving data analysis, customer service, operations, or administrative functions is a plus. Requirements - Motivated and eager to learn, with an interest in healthcare operations and improving processes. - Strong problem-solving and critical thinking skills, with the ability to analyze information and identify patterns. - Detail-oriented with a focus on accuracy and quality in work. - Good organizational and time management skills, with the ability to handle multiple tasks and meet deadlines. - Clear verbal and written communication skills, with the ability to work professionally with team members and others. - Customer-service oriented, with a helpful and responsive approach. - Basic to intermediate Microsoft Excel skills preferred (e.g., sorting, filtering, simple formulas; exposure to pivot tables or lookups is a plus). - Proficiency in Microsoft Office tools such as Excel, Word, Outlook, and PowerPoint. - Familiarity with CRM systems or data/reporting tools is a plus but not required. - Willingness and ability to quickly learn new systems, processes, and program rules. - Ability to work independently while also contributing as part of a team. - Demonstrates professionalism, accountability, and good judgment. Benefits - Remote - not to exceed 25 hours per week. - Monday through Friday, 9:00 AM – 5:00 PM (flexibility may be available based on academic schedule). - Compensation range: $19.24-$22.00/hourly.

Role Description The Tax Compliance Analyst ensures full compliance with local, state, and federal payroll tax rules and regulations while supporting the integrity of payroll tax systems and processes. This role is responsible for: - Researching regulatory updates - Maintaining compliance documentation - Collaborating with cross-functional teams, including Operations, Legal, and IT - Supporting audits and system enhancements - Providing guidance on payroll tax best practices Key Responsibilities - Payroll Compliance Expertise - Serve as the subject matter expert (SME) for payroll tax compliance and best practices. - Ensure payroll systems remain compliant with federal, state, and local tax regulations. - Manage compliance functions and partner with IT on system requirements. - Maintain compliance across all tax portions of gross-to-net payroll elements. - Regulatory Research & Interpretation - Research local, state, and federal payroll tax regulations and requirements. - Keep abreast of changes in payroll tax legislation and ensure timely application within internal processes. - Collaborate with Legal for interpretation of new or updated regulatory requirements. - Apply regulatory changes proactively to internal payroll processes and documentation. - Documentation, Auditing & Risk Management - Prepare, update, and maintain payroll tax requirements for documentation and procedures. - Draft and revise internal payroll tax process documents. - Support internal payroll tax audits and ensure no compliance steps are overlooked. - Identify potential tax compliance risks, recommend solutions, and implement corrective actions. - Cross-Functional Collaboration - Work closely with Operations, Legal, IT, HR, and Finance to ensure compliance is integrated across workflows. - Provide consultation on payroll tax best practices to internal stakeholders. - Partner with external vendors on compliance-related system updates and integrations. - Project & Vendor Support - Support payroll tax and system-related projects, including process improvements and documentation updates. - Demonstrate flexibility and adaptability during system or regulatory changes. - Assist with vendor management related to payroll tax compliance services. - General Support - Support functional areas with additional duties as assigned. - Maintain confidentiality of sensitive company and payroll information. Qualifications - BS/BA in Accounting, Business, or a related field preferred. - Substantial professional experience may be considered in lieu of a formal degree. - 5+ years of U.S. payroll tax experience required. - Proven work experience as a Payroll Tax Consultant, Payroll Tax Analyst, or similar roles. - Experience with payroll tax compliance, payroll tax systems, and cross-functional operations. - Certified Public Accountant (CPA) or EA (Enrolled Agent) strongly preferred. Requirements - Excellent knowledge of U.S. payroll tax regulations. - Experience with payroll software and Microsoft Office (especially Excel). - Strong project management and analytical skills. - Detail-oriented with strong mathematical aptitude. - Outstanding written and verbal communication skills. - Ability to work effectively within cross-functional teams and manage competing priorities. - Strong organizational and time management skills. - Self-motivated, results-oriented, and able to thrive in a fast-paced, evolving environment. - Ability to maintain confidential information with professionalism and integrity. Compensation - $80,000 - $90,000 annually. - This role is eligible for a base salary within the posted range. - Actual compensation will be determined based on a variety of factors, including skills, experience, and geographic location. - Compensation may vary for positions based in high cost-of-labor markets. Working Condition - Remote Supervisory Responsibility - N/A Company Description Public Partnerships is an Equal Opportunity Employer dedicated to celebrating diversity and intentionally creating a culture of inclusion. We believe that we work best when our employees feel empowered and accepted, and that starts by honoring each of our unique life experiences. At PPL, all aspects of employment regarding recruitment, hiring, training, promotion, compensation, benefits, transfers, layoffs, return from layoff, company-sponsored training, education, and social and recreational programs are based on merit, business needs, job requirements, and individual qualifications. We do not discriminate on the basis of race, color, religion or belief, national, social, or ethnic origin, sex, gender identity and/or expression, age, physical, mental, or sensory disability, sexual orientation, marital, civil union, or domestic partnership status, past or present military service, citizenship status, family medical history or genetic information, family or parental status, or any other status protected under federal, state, or local law. PPL will not tolerate discrimination or harassment based on any of these characteristics.

Role Description The Sr. Business Operations Associate is a strategic operational partner to the Operations Leadership team, enabling effective decision-making, execution, and communication. This role focuses on coordinating leadership priorities, strengthening operational rigor, and translating complex information into clear, executive-ready insights. The position requires strong independent organizational judgment, analytical thinking, and the ability to anticipate leadership needs in a fast-paced environment. Duties & Responsibilities - Leadership & Operational Support - Act as a central coordination point for the Operations Leadership team to ensure alignment across priorities, timelines, and stakeholders. - Manage leadership calendars and meeting preparation, ensuring leaders are well-prepared for key engagements. - Support execution of strategic initiatives by tracking progress, monitoring action items, and coordinating follow-ups. - Provide operational structure and organization to ensure initiatives are executed on time and at a high standard. - Identify and recommend process improvements to increase efficiency and reduce operational friction. - Plan and support leadership meetings, offsites, and team events, including logistics and materials. - Leads and manages complex, cross-functional projects with end-to-end thinking in mind. - Navigates and guides operational Leadership on competing priorities to ensure the right actions are taken timely. - Trusted advisor to senior operational leadership, staying one step ahead by anticipating and understanding needs for upcoming operational leadership, CLT and Board meetings. - Ties together data required for decision-making so outcomes are delivered accurately and timely. - Executive Communication & Presentations - Draft, edit, and manage internal communications on behalf of operations leadership. - Develop clear, compelling PowerPoint presentations for senior leadership and board-level audiences. - Synthesize data, strategy, and operational updates into concise, executive-ready narratives. - Prepare briefing materials, summaries, and presentations to support leadership decision-making. - Reporting, Analytics & Insights - Design, build, and maintain executive dashboards, KPIs, and recurring reports. - Ensure accuracy, consistency, and clarity across all reporting and performance metrics. - Translate complex operational, financial, or technical data into actionable business insights. - Validate the integrity of operational data, including tracking and trending results across teams. - Partner with leaders to identify insights, risks, and opportunities through data analysis. - Cross-Functional Collaboration - Partner with cross-functional teams to coordinate deliverables and ensure timely execution of initiatives. - Serve as a professional point of contact with internal and external stakeholders at all levels. - Build strong working relationships across the organization to support leadership goals and operational effectiveness. Qualifications - Education: Bachelor’s degree or equivalent relevant experience. Substantial professional experience may be considered in lieu of a formal degree. - Experience: 8+ years of experience in business operations, executive support, or a comparable role supporting senior leadership. Requirements - Exceptional organizational skills with the ability to manage multiple priorities and deadlines. - Strong written and verbal communication skills, with executive-level presence. - Demonstrated ability to influence outcomes and support decision-making. - Proactive problem-solving and critical-thinking capabilities. - High degree of ownership, accountability, and attention to detail. - Ability to handle confidential and sensitive information with discretion. - Advanced proficiency in Microsoft Office 365 (Outlook, Word, Excel, PowerPoint); experience with Microsoft Project and/or Visio is a plus. - Strong skills in spreadsheet development, reporting, and data analysis. Benefits - 401k Retirement Plan - Medical, Dental and Vision insurance on first day of employment - Generous Paid Time Off - Employee Assistance Program and more Compensation Compensation range: $80,000 - $120,000 annually. This role is eligible for a base salary within the posted range. Actual compensation will be determined based on a variety of factors, including skills, experience, and geographic location. Compensation may vary for positions based in high cost-of-labor markets. Company Description Public Partnerships LLC supports individuals with disabilities or chronic illnesses and aging adults, to remain in their homes and communities and “self” direct their own long-term home care. Our role as the nation’s largest and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and services within their state-approved personalized budget. We are appointed by states and managed healthcare organizations to better serve more of their residents and members requiring long-term care and ensure the efficient use of taxpayer funded services.

Role Description Seeking a detail-obsessed business analyst who thrives on turning complex contracts into clear, actionable requirements. The ideal candidate will possess a blend of analytical expertise, domain knowledge (Medicaid), and experience managing requirements in cross-functional government programs. Key Responsibilities - Contract Analysis: Review state government RFP documentation to identify deliverables and operational/technical requirements for Medicaid programs. - Requirements Gathering: Facilitate working sessions with internal stakeholders and technical teams to identify and document business requirements and functional specifications. - Process Mapping: Analyze current processes and workflows, identify gaps, and recommend process improvements. - Stakeholder Management: Engage with key stakeholders to ensure alignment of project goals and objectives through requirements. - Documentation: Create a requirements traceability matrix for each project, along with detailed functional specifications, user stories, and process flows as needed. - Facilitate Workshops: Lead workshops and meetings as needed to gather input from multiple stakeholders and ensure effective communication. - Compliance and Standards: Ensure all processes and requirements comply with PPL company policies and PMO standards. - Project Coordination: Support project timelines and milestones to ensure successful and timely delivery of deliverables. Qualifications - Education: Bachelor’s degree in related field. Substantial professional experience may be considered in lieu of a formal degree. - Experience: 4+ years of experience serving as primary BA on requirements-driven projects. Extensive experience analyzing contracts for business and technical requirements. Prior experience in Medicaid financial management services is a benefit. - Certification: Certified Business Analyst Professional (CBAP) preferred. May substitute certification for applicable experience. Requirements - Technical Skills: Proficiency in documenting requirements, process flows, and use cases using tools such as Visio, Jira, or equivalent. Familiar with MS project and other modern project management tools. - Detail Oriented: Ability and desire to parse contracts on a regular basis to extract and interpret all requirements. - Communication: Excellent written and verbal communication skills to interact with cross-functional teams across the company. - Problem-Solving: Identify gaps or conflicts in customer requirements and tenaciously seek resolution. Strong critical-thinking skills. - Organization: Ability to create or utilize existing structures for organizing and relating information to project goals and deliverables. - Adaptable to Delivery Methods: Ability to operate in waterfall, agile, and hybrid environments. Benefits - 401k Retirement Plan - Medical, Dental and Vision insurance on first day of employment - Generous Paid Time Off - Continuing Education Assistance Program - Employee Assistance Program - Compensation Range: $90,000 - $120,000 annually

Role Description Public Partnerships LLC supports individuals with disabilities or chronic illnesses and aging adults, to remain in their homes and communities and “self” direct their own long-term home care. Our role as the nation’s largest and most experienced Financial Management Service provider is to assist those eligible Medicaid recipients to choose and pay for their own support workers and services within their state-approved personalized budget. We are appointed by states and managed healthcare organizations to better serve more of their residents and members requiring long-term care and ensure the efficient use of taxpayer funded services. The Enrollment Specialist guides individuals through the participant-directed services enrollment process, ensuring timely documentation, coordination, and education. This role provides person-centered support, resolves barriers, and trains participants on program requirements, financial management systems, and fraud prevention to promote successful self-direction. Key Responsibilities - Enrollment Coordination - Follows up on referrals for participant-directed services. - Supports the individual/employer and their provider(s) in completing all necessary documentation required for enrollment. - Performs all functions necessary to support the enrollment of the individual/employer/authorized representative and provider(s) including processing enrollment documentation, obtaining employer identification numbers, completing criminal background checks, and other enrollment related requirements. - Communicates referral corrections, as needed, to entities providing case management or service/support coordination services to the individual. - Updates enrollment status of individual participants and providers through portal and records in systems. - In collaboration with the enrollment supervisor, supports workforce management delegation to ensure service levels are met. - Participant Education and Support - Educates the individual/employer on interacting with Public Partnerships as their fiscal intermediary, with emphasis on their authorized services, timesheet completion, enrolling subsequent providers and keys to successful self-direction. - Provides person-centered, need-based program education and guidance to Participants and authorized representatives specific to individual choices, goals and desired outcomes. - Explains and educates on Participant/authorized representative and provider roles and responsibilities for participation in self-directed services, including processing payroll, vendor payments, tax withholding and reporting. - Provides direct, including train-the-trainer, instruction on how to navigate program rules, expectations and Financial Management Systems, including online enrollment, service time capture, portal and emerging technologies. - Provides train-the-trainer instruction on identification and reporting of suspected fraud, abuse, neglect and exploitation. - Problem-Solving and Barrier Resolution - Identifies potential barriers and bottlenecks to timely enrollment and takes necessary steps to triage and resolve. - Engages the entity providing case management or service/support coordination services to the individual to ensure timely coordination of service approval and authorization. - Collaborates with internal and external stakeholders as necessary to ensure enrollment cycle times are minimized and the first payment to the provider(s) is received on time and in full. - Compliance and Risk Management - Identifies, reports and appropriately follows up on allegations or reports of suspected fraud. - Assesses for participant abuse, neglect, and exploitation, following the appropriate reporting protocol where necessary. - Maintains documentation of services provided and time committed in accordance with applicable policies and procedures. - Documents and reports evidence of individual’s inability to self-direct appropriately. - Participant Assessment - Assesses Participant’s and/or authorized representative’s ability to communicate, acquire new information, act as an employer and otherwise successfully participate in a self-directed employer and/or budget authority service model. - Communicates with Participant or authorized representative about additional supports or accommodations necessary for successful program participation. - Performs in-home visits of Individuals as applicable by program. Qualifications - Education: Related Bachelor’s Degree Preferred; can be substituted with 1+ years of related experience. - Substantial professional experience may be considered in lieu of a formal degree. - Experience: Minimum of one (1) year of experience serving individuals with disabilities and/or aging adults preferred. Requirements - Strong customer service and support experience. - Proficient in Microsoft Office Suite, CRM, Five 9, My Account platforms and web-based applications. - High aptitude for process assessment, improvement, and recommendations. - Exceptional verbal and written communication skills. - Ability to develop strong working relationships with external and internal stakeholders. Benefits - 401k Retirement Plan. - Medical, Dental and Vision insurance on first day of employment. - Generous Paid Time Off. - Continuing Education Assistance Program. - Employee Assistance Program. Compensation Range $21.63/hour - $23.13/hour

Role Description The Medicaid Billing Clerk serves as a trusted resource for managing the revenue cycle operations that are critical to ensuring strong organizational cash flow, low denial rates, efficient denial root cause analysis, and mitigation of bad debt outcomes. This role optimizes various external and internal platforms to enhance bottom-line results and directly supports the Revenue Cycle Management Team in maintaining payer-specific revenue cycle success. Key Responsibilities - Billing Operations & Claims Management - Prepare and manage weekly billing activities and invoice submissions. - Prepare and re-submit corrected claims or invoices as needed. - Bill payers by inputting billing information into databases. - Appeal denied claims utilizing clearinghouse or payer portal functionality. - Reconciliation, Reporting & Revenue Accuracy - Reconcile billing activities between clearinghouse and host systems. - Reconcile payments and perform denial research using database queries and spreadsheet analysis. - Verify and maintain accurate receivable balances across multiple information systems. - Prepare reports based on Medicaid billing data and revenue. - Adjust patient bills by reviewing remittance advice and consulting with management. - Resolve billing discrepancies by conducting research and correcting errors. - Collections, Denials & Payment Resolution - Perform minimal business-to-business collection activity to maintain low and current receivable balances. - Follow up on delinquent payer remittances and payments. - Escalate emerging denial trends and determine root cause analyses. Qualifications - Education: Related Bachelor’s degree preferred; can be substituted with 1+ years of related experience. - Experience: Minimum of 3 years of experience in medical billing; experience in self-directed work environments a plus. - Certification: Relevant medical billing or coding certification preferred. Requirements - Knowledge of medical billing terminology. - Proficiency with medical billing and clearinghouse systems. - Strong attention to detail and organizational skills. - Excellent verbal and written communication skills. - Proficient knowledge of Microsoft Excel. - High level of data entry accuracy and speed. Benefits - If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!