Manage end-to-end medical billing operations with a focus on Medicaid: submit claims, resolve denials and appeals, coordinate with clinicians and billing partners, support payor onboarding, maintain records, generate performance reports, and assist patients with coverage and billing inquiries to maximize reimbursement and access to care.
Unless otherwise noted, all positions are fully remote with work permitted from the following states: CA, CO, IL, MA, MD, NJ, NY, OR, and WA.
We are living through a pivotal moment for reproductive and sexual health—and Hey Jane is uniquely positioned to help.
From day one, we've been committed to providing safe, discreet medication abortion treatment—and have helped more than 100,000 people get the care they need. Today, we offer a range of reproductive and sexual health care services from the comfort and convenience of your phone. Our in-house clinical care team, composed of board certified doctors, advanced practice clinicians, nurses, and patient care advocates, is just a text message away. We’re committed to helping our patients get safe, discreet, judgment-free virtual health care, from a team that truly cares.
Role Overview
As Hey Jane expands to partner with more payers, we are seeking a highly organized and detail-oriented Billing Specialist with specific expertise in Medicaid. You are someone who thrives in dynamic environments and is motivated by the opportunity to help more patients access care with fewer out-of-pocket costs.
In this role, you will manage the smooth and efficient handling of billing operations, ensuring our workflows and claims remain in strict accordance with coding standards. You will act as a crucial bridge between our Clinical and Clinical Operations teams and our third-party billing partner. From accurately processing claims to resolving complex billing issues and maintaining compliance, you will ensure that the intricacies of insurance reimbursement never slow down our mission.
The ideal candidate has a strong background in medical billing and coding and possesses the analytical skills to navigate the nuances of state-funded programs. You excel at spotting gaps, creating structure where it’s needed, and being persistent in communications to ensure our clinicians can focus on patients rather than administrative hurdles.
Why this role matters
This isn’t your average administrative role: the systems you maintain and improve directly determine how quickly and effectively patients can access safe, timely, and compassionate care. By mastering the complexities of Medicaid, you are personally expanding healthcare equity and ensuring that financial barriers don't stand in the way of essential services. In a moment where access to care is more important than ever, your work will have a tangible impact on the future of accessible healthcare across the U.S.
Responsibilities
- Ensure a smooth, efficient, and timely claim submission process with minimal denials, including identifying gaps in claims
- Follow up on unpaid claims, denials, and appeals to ensure maximum reimbursement
- Investigate and resolve billing discrepancies or coding issues
- Collaborate with internal teams, including clinicians, to provide charting requirements and necessary documentation for claims submission, training team members on billing processes, and creating workflows for billing operations
- Provide support and guidance to patients regarding their insurance coverage, financial assistance, and billing inquiries
- Manage abortion fund invoicing and reimbursements
- Maintain accurate and organized billing records and documentation
- Generate and analyze reports to monitor billing performance and identify areas for improvement
- Support new payor partnerships, working collaboratively with internal and external stakeholders to own billing and coding workflows as we grow
- Maintain knowledge of current billing and coding regulations and updates
- Stay up-to-date with changes in insurance policies, fee schedules, and reimbursement rates
- Assist with other billing-related tasks as needed
Requirements
- 2+ years experience as a Billing Specialist in a healthcare setting (preferably in a telehealth setting)
- Deep expertise in Medicaid billing guidelines, including familiarity with state-specific reimbursement rules and eligibility verification
- Strong proficiency in ICD-10, CPT, and HCPCS coding, particularly as they relate to abortion services and sexual and reproductive health
- Proven experience managing the full claims lifecycle, including submission, denial management, and appeals
- Hands-on experience with Electronic Health Records (EHR) and Revenue Cycle Management (RCM) systems
- Solid understanding of HIPAA regulations and a strict commitment to maintaining patient data privacy
- Strong attention to detail and accuracy
- Ability to effectively communicate with patients, insurance companies, and internal stakeholders
- Proficient in using Excel or Google Sheets
- Ability to work independently in a fast-paced environment
- Strong organizational and time management skills
- Passion for advancing equitable healthcare, with a deep-rooted ability to empathize with Hey Jane patients
At Hey Jane, we work towards the vision of having equitable healthcare, changing the status quo, and rebuilding the way people experience healthcare—and bring that same vision to our workplace. We’re an equal opportunity employer committed to building an inclusive environment, and encourage all applicants from every background and life experience.
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