A Billing Specialist performs administrative work at financial institutions and banks that handle bills, receipts, and invoices. Manages the status of client accounts and tracks financial records, charges, and receipts of the accounts.
Center for Transitional Living are seeking an experienced Medicaid Billing & Program Specialist to support our rapidly growing Medicaid home care operations in Michigan and Connecticut . The ideal candidate will have direct experience with Michigan Medicaid Home Help , CHAMPS , and/or Connecticut Medicaid waiver programs , including CHCPE, DDS, ABI, MFP/CSP, and other long-term services and supports (LTSS). This individual will serve as a subject matter expert for billing operations, provider enrollment, claims resolution, Medicaid compliance, and payer navigation while helping support agency growth across both states. Responsibilities Manage Michigan and Connecticut Medicaid billing and claims processes. Submit, track, reconcile, and resolve MDHHS Home Help and Connecticut Medicaid claims. Work within CHAMPS to maintain provider enrollments, updates, revalidation, and compliance requirements. Navigate Connecticut Medicaid billing portals and payer systems. Identify and resolve claim denials, rejections, payment issues, and billing discrepancies. Coordinate with MDHHS, Connecticut
DSS, CHAMPS
support, Gainwell, Medicaid Managed Care Organizations (MCOs), and agency staff regarding billing concerns. Monitor payment activity, accounts receivable, and reimbursement trends. Assist with provider enrollment, credentialing, and ongoing compliance requirements. Support audits, compliance reviews, and documentation requests. Develop billing workflows, internal procedures, and process improvements to maximize collections. Train administrative staff on Michigan and Connecticut Medicaid billing requirements. Serve as an internal resource for Medicaid policy questions and operational guidance. Assist leadership with implementation of new Medicaid programs, payer contracts, and expansion initiatives. Connecticut Programs Experience with one or more of the following is preferred: Connecticut Home Care Program for Elders (CHCPE) Department of Developmental Services (DDS) Acquired Brain Injury (ABI) Waiver Money Follows the Person / Community Support Program (MFP/CSP) Community First Choice and other Connecticut Medicaid waiver services Connecticut DSS provider enrollment and billing Gainwell Technologies provider portal Michigan Programs Experience with one or more of the following is preferred: MDHHS Home Help Program CHAMPS provider enrollment and maintenance Michigan Medicaid provider billing HHAeXchange / Electronic Visit Verification (EVV) Medicaid Managed Care Organizations including Molina Healthcare, Humana Healthy Horizons, Aetna Better Health, Priority Health, UnitedHealthcare Community Plan, and Blue Cross Complete Provider credentialing and revalidation Required Qualifications Minimum of 2 years of Medicaid billing experience . Strong knowledge of Michigan Medicaid and/or Connecticut Medicaid programs. Experience working with CHAMPS and/or Connecticut Medicaid billing systems. Experience resolving Medicaid claim denials, payment issues, and billing discrepancies. Understanding of Medicaid provider enrollment and compliance requirements. Strong organizational, analytical, and communication skills. Ability to work independently while managing multiple priorities. Preferred Qualifications Experience working for a Medicaid home care, home health, or long-term services agency. Experience supporting Medicaid waiver programs. Knowledge of EVV systems, including HHAeXchange. Experience with provider credentialing and payer contracting. Experience supporting agency growth, start-up operations, or multi-state Medicaid programs
