Healthcare Billing Specialist

ABOUT SENIORVERSE:
Seniorverse is a U.S.-based software company focused on senior care. Our modern, all-in-one platform helps adult day centers replace slow, manual processes with a secure and easy-to-use system — covering attendance tracking, care management, compliance reporting, and billing all in one place. Our mission is simple: give adult day centers more time for what matters most — the people they serve.

We are looking for a skilled Billing Specialist to play a key role in our client success process. You will help ensure that our client centers are set up correctly inside the Seniorverse platform and ready to submit accurate claims through Stedii (a U.S. medical billing clearinghouse) — so their billing runs smoothly from the very start.

ABOUT THE ROLE:
The Billing Specialist is a key member of the Seniorverse customer success and operations ecosystem. You will be responsible for configuring billing within the Seniorverse platform and setting up adult day center customers within Stedii for accurate, timely claims submission. You'll serve as the internal expert on payer requirements — including Medicaid single-payor states, Managed Care Organizations (MCOs), and private pay — and will be the go-to resource for navigating billing codes and resolving claim rejections.

This role is equal parts technical configuration, payer expertise, and client support. The right candidate is someone who can translate complex billing requirements into clean platform setups and who takes pride in keeping revenue flowing smoothly for the centers we serve.

KEY RESPONSIBILITIES:
1) Payer & Billing Expertise
• Apply in-depth knowledge of Medicaid billing requirements across single-payor states, including state-specific authorization workflows, Eligibility Verification Systems (EVS), and submission timelines relevant to adult day services
• Navigate MCO billing protocols and contract requirements, ensuring client setups are tailored to each plan
• Process and support private pay billing, including invoicing workflows and client account management
• Maintain current knowledge of applicable billing codes (HCPCS, CPT, ICD-10) and how they apply in adult day center and community-based services settings
• Monitor and communicate payer policy updates that may affect platform configuration or client reimbursement

2) Platform Configuration & Customer Setup
• Configure billing settings within Seniorverse for new and existing adult day center customers, ensuring accurate alignment with each client's payer mix, service types, and authorization parameters
• Set up customer accounts within Stedii for claims submission, including payer enrollment, service code mapping, and authorization entry
• Validate billing configurations prior to go-live to ensure clean first-pass claim submissions
• Maintain and update billing configurations as payer requirements or client contracts change

3) Claims Submission & Revenue Cycle Support:
• Oversee and support the claims submission process across Medicaid (single-payor states), MCOs, and private pay on behalf of client centers
• Monitor claim status through adjudication and payment posting, identifying patterns that indicate configuration or process gaps
• Analyze, correct, and resubmit rejected or denied claims in a timely manner, documenting root causes and implementing corrective measures
• Track and report on claim rejection rates and resolution timelines, surfacing trends to the product and operations teams

4) Client & Internal Collaboration:
• Partner closely with Seniorverse's onboarding, customer success, and product teams to ensure billing configuration is seamlessly integrated into the client launch process
• Serve as a knowledgeable, responsive point of contact for client centers navigating billing questions, rejections, or payer disputes
• Contribute feedback to the product team on billing-related platform improvements based on real-world client needs
• Support internal training efforts by documenting billing workflows, payer nuances, and configuration best practices

QUALIFICATIONS:
1) Required Qualifications
• Minimum 3 years of experience in healthcare billing with direct experience across Medicaid (single-payor states), MCOs, and private pay
• Demonstrated experience configuring billing within healthcare or human services software platforms
• Proficiency with Stedii or comparable clearinghouse/claims management platforms
• Strong working knowledge of billing codes (HCPCS, CPT, ICD-10) as applied in adult day, home care, or community-based services
• Proven track record of managing claim rejections and denials — including analysis, correction, and resubmission — with measurable outcomes
• Proficiency in English with excellent written and verbal communication skills; ability to explain complex billing concepts clearly to non-billing audiences
• Exceptional attention to detail and organizational skills, with the ability to manage multiple client configurations simultaneously
• Comfortable working independently in a fast-paced, tech-forward environment

2) Preferred Qualifications:
• Direct experience with billing management platforms
• Familiarity with Medicaid, MLTC plans, and/or adult daycare (ADC) billing
• Experience supporting SaaS platform customers in a billing configuration or implementation capacity
• Knowledge of EVS processes and prior authorization workflows
• Associate's or Bachelor's degree in Health Information Management, Business Administration, or a related field

WHY SENIORVERSE:
• Be part of a mission-driven team improving operations for adult day centers across the country
• Work at the intersection of healthcare, technology, and real human impact
• Collaborative, supportive team culture with room to grow
• Competitive compensation and benefits
• Flexible work environment

HOW TO APPLY:
• Send your application through OnlineJobs.ph with the subject line "Adult Day Billing Specialist"
• In your message, include:
1) A brief explanation of why this role is a good fit for your skills and experience
2) One specific example of billing work you have done previously (what you billed, what system or process you used, and the outcome)
3) Your familiarity with the U.S. senior care industry or related healthcare experience
4) A copy of your resume
5) Confirmation that you are available to work *Monday – Friday, 9:00 AM – 4:00 PM Eastern Time (ET)*

We review applications on a rolling basis and will be in touch promptly.

Seniorverse is an equal opportunity employer committed to building a diverse and inclusive team.