Medicaid/Medicare Billing Representative (169754)

Job description:

Medicaid/Medicare Billing Representative (169754) – Harrisburg, PA 17101 | $20.75/hr
Assignment Dates: May 2026 – January 2027

Schedule : Mon-Fri 8a-4p
Job Type: Temp-to-perm (opportunity to extend or convert to permanent based on business needs)

A-Line Staffing is now hiring a Financial Representative in Harrisburg, Pennsylvania 17101 - please contact Staffing Manager, Tiona Scroggins @

Position Overview:
This role supports monitoring, compliance, and financial review activities within long-term care programs. The Financial Representative 2 is responsible for analyzing financial and program data, ensuring compliance with state and federal regulations, and supporting quality improvement initiatives across healthcare and human services programs.

Key Responsibilities:

• Perform financial and compliance reviews of programs and service providers
• Analyze programmatic and financial data to determine effectiveness and compliance
• Conduct desk and on-site monitoring reviews
• Ensure adherence to regulatory standards, contract requirements, and performance measures
• Identify performance gaps and recommend corrective actions
• Develop and manage reports, presentations, and documentation
• Provide technical assistance to providers regarding billing and regulatory requirements
• Review accounts receivable and identify overpayments
• Manage recovery of overpaid claims and maintain reporting documentation
• Compare financial and census data for accuracy and compliance
• Conduct entrance and exit conferences with facility staff
• Respond to inquiries from stakeholders and provide regulatory guidance
• Maintain and update databases for reporting and analysis
• Participate in audits, investigations, and special projects
• Collaborate with internal teams and external agencies
• Attend hearings and support findings related to financial reviews
• Perform additional duties as assigned

Required Qualifications:

• Bachelor’s degree OR a combination of education and relevant experience
• Working knowledge of Medicaid and Medicare billing regulations
• Strong analytical and problem-solving skills
• Ability to interpret policies, procedures, and regulatory guidelines
• Experience with financial reviews, audits, or compliance activities
• Strong written and verbal communication skills
• Ability to work independently and make decisions based on established guidelines
• Proficiency in data analysis and reporting tools
• Ability to manage multiple priorities and deadlines
• Strong attention to detail and accuracy

Preferred Qualifications:

• Experience with healthcare accounts receivable and cost reporting
• Experience working with long-term care or nursing facility billing
• Familiarity with regulatory compliance in healthcare or human services

Essential Functions:

• Collect, analyze, and interpret program and financial data
• Analyze and apply policies, procedures, and regulations
• Review and evaluate program performance and compliance
• Communicate effectively both verbally and in writing
• Build and maintain professional working relationships

Candidate Must Know Before Applying:

• Role involves extensive compliance monitoring and financial analysis
• Requires knowledge of healthcare billing (Medicaid/Medicare)
• Includes both independent work and collaboration with multiple stakeholders
• May involve on-site reviews and audits
• Requires handling sensitive financial and program data
• Strong attention to detail and regulatory adherence is critical
• Involves frequent communication with providers and internal teams
• Must be comfortable working in a structured, policy-driven environment
• Participation in hearings, reporting, and corrective action planning may be required

Benefits:

• Benefits are available to full-time employees after 90 days of employment
• A 401(k) with company match is available after 1 year of service

INDKS

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Vision insurance

Experience:

• healthcare billing : 1 year (Required)
• Medicaid/Medicare billing: 1 year (Required)

Work Location: In person

• Key Responsibilities:

  • Perform financial and compliance reviews of programs and service providers
  • Analyze programmatic and financial data to determine effectiveness and compliance
  • Conduct desk and on-site monitoring reviews
  • Ensure adherence to regulatory standards, contract requirements, and performance measures
  • Identify performance gaps and recommend corrective actions
  • Develop and manage reports, presentations, and documentation
  • Provide technical assistance to providers regarding billing and regulatory requirements
  • Review accounts receivable and identify overpayments
  • Manage recovery of overpaid claims and maintain reporting documentation
  • Compare financial and census data for accuracy and compliance
  • Conduct entrance and exit conferences with facility staff
  • Respond to inquiries from stakeholders and provide regulatory guidance
  • Maintain and update databases for reporting and analysis
  • Participate in audits, investigations, and special projects
  • Collaborate with internal teams and external agencies
  • Attend hearings and support findings related to financial reviews
  • Perform additional duties as assigned