Part Time Claim Reviewer Jobs (NOW HIRING)

Department: Children's Long-Term Support (CLTS) Program
Reports To: Program Director/Clinical Director
Employment Status: Part-Time
Classification: Hourly, Non-Exempt

Bridging Gapss, LLC is seeking a detail-oriented and organized Part-Time CLTS Biller to oversee all billing functions related to the Wisconsin Children's Long-Term Support (CLTS) Program. This position is responsible for ensuring that services are billed accurately and timely while maintaining compliance with CLTS policies, Medicaid requirements, and agency standards.

The CLTS Biller will work closely with the Program Director, Clinical Director, Intake Coordinator, and Direct Support Professionals to verify documentation, resolve billing discrepancies, monitor authorizations, and ensure all required documentation is complete before claims are submitted for payment.

• Prepare, review, and submit CLTS claims accurately and timely.
• Verify that all service documentation is complete before billing.
• Ensure billing matches approved authorizations and service plans.
• Review progress notes for billing compliance.
• Compare service dates, units, and service codes against authorizations.
• Submit claims within required payer deadlines.
• Track claim submissions and payment status.
• Identify and resolve denied, rejected, or pending claims.
• Process billing corrections and claim resubmissions when necessary.
• Maintain billing records in accordance with agency and state requirements.

• Review staff documentation for completeness and accuracy.
• Verify:
• • Correct client name
  • Date of service
  • Service code
  • Start and end times
  • Billable units
  • Detailed intervention provided
  • Client response
  • Progress toward goals
  • Required staff signatures
• Ensure documentation supports services billed.
• Notify supervisors of missing or incomplete documentation.

• Monitor client service authorizations.
• Track remaining authorized units.
• Notify supervisors when authorizations are nearing expiration.
• Ensure services are not billed beyond approved authorization limits.
• Assist with obtaining updated authorizations when needed.

• Maintain compliance with:
• • Wisconsin CLTS Program requirements
  • Medicaid regulations
  • HIPAA regulations
  • Agency billing policies
• Protect confidential client information.
• Report billing discrepancies immediately.
• Assist with internal billing audits.

• Generate weekly billing reports.
• Monitor outstanding claims.
• Track unpaid invoices.
• Report denied claims.
• Provide monthly billing summaries.
• Assist leadership with financial reporting related to CLTS services.

• Work closely with:
• • Program Director
  • Clinical Director
  • Intake Coordinator
  • Resource Specialist
  • Direct Support Professionals
• Communicate documentation deficiencies to staff.
• Provide guidance regarding billing documentation requirements.
• Assist staff in correcting documentation errors before billing.

• Maintain organized electronic billing files.
• Update billing spreadsheets and tracking logs.
• Assist during state audits and quality assurance reviews.
• Participate in staff meetings as requested.
• Complete additional administrative duties assigned by leadership.

• High School Diploma or GED required.
• Associate's Degree in Healthcare Administration, Business, Accounting, or related field preferred.
• Minimum of one (1) year of medical billing, Medicaid billing, or CLTS billing experience preferred.
• Experience with Wisconsin Medicaid or Children's Long-Term Support (CLTS) billing is highly preferred.
• Knowledge of HIPAA and confidentiality regulations.
• Strong organizational and time management skills.
• Excellent written and verbal communication skills.
• Ability to work independently with minimal supervision.
• Strong attention to detail and accuracy.

• Experience using electronic health records (EHR) systems.
• Experience reviewing progress notes and service documentation.
• Experience with Medicaid billing software.
• Familiarity with NoteHouse documentation system (preferred).
• Experience working with fee-for-service programs.

• Strong computer proficiency (Microsoft Office Suite, Google Workspace)
• Data entry accuracy
• Billing reconciliation
• Claims management
• Problem-solving skills
• Time management
• Organization
• Professional communication
• Ability to maintain confidentiality
• Attention to detail
• Ability to meet strict deadlines

• Part-Time
• Approximately 15–25 hours per week
• Flexible schedule based on agency needs
• Occasional attendance at staff meetings may be required

The Part-Time CLTS Biller will be expected to:

• Submit claims accurately and on time.
• Maintain a billing accuracy rate of at least 98%.
• Review documentation before claim submission.
• Identify billing issues proactively.
• Meet all billing deadlines.
• Maintain confidentiality and compliance with HIPAA and Medicaid regulations.
• Communicate effectively with staff regarding billing corrections.
• Support the financial health of the CLTS program through timely and compliant billing practices.

At Bridging Gapss, LLC, we are committed to improving the lives of children and families through quality services and compassionate care. As our Part-Time CLTS Biller, you will play a vital role in ensuring the financial sustainability of our programs while supporting a team dedicated to making a meaningful impact in the community.

By applying to this job, you agree to receive periodic text messages from this employer and Homebase about your pending job application. Opt out anytime. Msg & data rates may apply.
Powered by Homebase. Free employee scheduling, time clock and hiring tools.