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ALI FORNEY CENTER

Social Care Network Billing Specialist

Job Description

The Ali Forney Center (AFC) protects LGBTQ+ youth from homelessness and helps them build the tools needed to live independently. Founded in 2002, AFC provides housing, healthcare, and educational support to thousands of youth each year. AFC creates an affirming, supportive environment where LGBTQ+ youth can thrive. The Social Care Network (SCN) Billing Specialist is responsible for preparing, reviewing, submitting, and reconciling monthly SCN billing and reimbursement documentation related to Medicaid 1115 Waiver Health-Related Social Needs (HRSN) services. The Billing Specialist works closely with program teams to ensure service documentation is accurate, timely, compliant, and properly entered into the SCN IT Platform to support reimbursement for screenings, navigation, nutrition services, housing supports, and enhanced care management activities. Key Responsibilities Prepare and submit monthly billing and reimbursement documentation for SCN-funded services. Review service documentation for completeness, compliance, and billing eligibility prior to claim submission. Monitor billing activity for screenings, navigation services, enhanced HRSN services, nutrition supports, and housing-related services. Track payments, denials, recoupments, corrections, and outstanding claims. Coordinate with program staff to resolve missing documentation, incomplete referrals, or billing discrepancies. Maintain accurate billing records and reimbursement reports. Assist with audits, monitoring reviews, reconciliation processes, and financial reporting. Ensure billing activities comply with
NYSDOH, OHIP, SCN
Operations Manual, Medicaid, and MCO requirements. Support data entry and quality assurance activities within the SCN IT Platform. Work collaboratively with AFC finance, compliance, and program leadership teams. Identify trends, operational inefficiencies, or compliance concerns impacting reimbursement.
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