Disability Inclusion Administrator & Billing Specialist

ESSENTIAL FUNCTIONS

1)      Billing & Contract Management – 40 %

a)      Proactively manage service authorizations (AFPs), service agreements, and employment-related documentation to ensure compliance prior to service delivery

b)      Take ownership of billing workflows by identifying risks, delays, or inefficiencies and implementing improvements

c)      Monitor contract timelines and anticipate upcoming expirations or gaps in authorization

d)      Generate invoices and ensure submission within required timelines, proactively resolving discrepancies

e)      Conduct ongoing quality assurance to ensure billing accuracy and alignment with contract requirements

f)       Track and follow up on outstanding authorization requests to prevent delays in service delivery

g)      Ensure accurate Medicaid billing by exporting and submitting ODDS data into eXPRS

2)      Data Management, Case Management Support, & Reporting – 20%

a)      Regularly analyze data quality and identify inconsistencies, gaps, or risks impacting compliance or reporting

b)      Develop clear, actionable reports and visualizations for leadership decision-making

c)      Maintain systems that ensure data continuity, accessibility, and integrity across platforms

d)      Regularly audit data and take initiative to correct or escalate issues

3)      SETWorks Administration & Data Integrity – 20%

a)      Serve as the primary administrator of SETWorks, overseeing system structure, functionality, and ongoing optimization

b)      Act as the main point of contact and liaison between Relay and SETWorks for troubleshooting, updates, and system enhancements

c)      Manage user access, permissions, and onboarding for new employees

d)      Provide training and ongoing support to staff on SETWorks and related processes

e)      Develop and refine workflows, forms, and tools to improve efficiency and data quality

f)       Identify and resolve system issues or inefficiencies

g)      Initiate conducting routine audits to ensure data integrity and audit readiness

h)      Lead data coordination and system support during audits, licensing reviews, and reporting requests

4)      Reporting, Planning, & Project Support – 15 %

a)      Maintain and improve SOPs to ensure consistency and clarity across processes

b)      Independently prioritize workload based on deadlines, risk, and impact

c)      Use structured planning systems (calendar, trackers) to ensure accountability and follow-through

d)      Communicate proactively with leadership about progress, risks, and needed support

e)      Track and manage projects with a focus on timely completion and continuous improvement

5)      Other Duties – 5 %

a)      Stay current on system updates

b)      Engage in professional development

c)      Support additional administrative needs

MINIMUM QUALIFICATIONS

·         2 years administrative experience in compliance-driven environments

·         1 year billing experience

·         Experience with case management systems

·         Strong Microsoft Office skills

·         Knowledge of HIPAA and data security

·         Strong organization and communication skills

PREFERRED QUALIFICATIONS

·         Bachelor’s degree in related field

·         Experience with SETWorks or eXPRS

·         Experience building tracking systems or SOPs

·         Experience with VR, ODDS, or similar programs

KNOWLEDGE, SKILLS, AND ABILITIES

Knowledge:

·         Strong knowledge of data management best practices, including accuracy, integrity, audit readiness, and confidentiality

·         Advanced working knowledge of Microsoft Office Suite, particularly Excel (e.g., formulas, pivot tables, data visualization, and reporting tools)

·         In-depth understanding of case management systems (preferably SETWorks), including system structure, user access, workflows, and reporting functionality

·         Knowledge of HIPAA compliance, data protection standards, and secure information management practices

·         Understanding of billing processes, authorization requirements, and documentation standards for publicly funded programs (e.g., VR, ODDS, Medicaid/eXPRS)

·         Knowledge of licensing, audit, and grant reporting requirements within nonprofit or human services environments

·         Understanding of system administration principles, including user access management, troubleshooting, and vendor coordination

Skills:

·         Strong system administration and management skills, including maintaining, optimizing, and troubleshooting case management systems (e.g., SETWorks)

·         Skilled in developing, improving, and maintaining workflows, tracking systems, and data processes across multiple platforms

·         Strong analytical skills, including the ability to identify data inconsistencies, trends, and risks and take action to resolve them

·         Excellent written and verbal communication skills, including the ability to train staff and translate technical processes into clear, accessible guidance

·         Strong attention to detail with high-level quality assurance skills to ensure accuracy in data, billing, and documentation

·         Skilled in developing and maintaining SOPs, internal controls, and audit-ready systems

·         Effective project and time management skills, with the ability to prioritize independently and manage multiple deadlines

·         Strong troubleshooting and problem-solving skills, including the ability to work with internal teams and external vendors to resolve system issues

Abilities:

·         Ability to take ownership of systems, workflows, and outcomes, ensuring smooth and efficient operations without reliance on task-by-task direction

·         Ability to anticipate risks, gaps, and inefficiencies in data, billing, and system processes and implement solutions

·         Ability to manage and administer a case management system, including user access, training, troubleshooting, and continuous improvement

·         Ability to serve as a liaison between internal teams and external system vendors, effectively communicating needs and driving resolution

·         Ability to collect, synthesize, and present data in formats appropriate for leadership, auditors, and external partners

·         Ability to work independently while coordinating across multiple teams and priorities

·         Ability to maintain organized, audit-ready documentation and ensure compliance across systems and processes

·         Ability to train, support, and reinforce staff use of systems, processes, and best practices

·         Ability to manage workload through structured planning, task tracking, and proactive communication of progress and risks

·         Ability to adapt to evolving systems, compliance requirements, and program growth while maintaining high performance and accuracy

SCOPE & ACCOUNTABILITY

This role ensures the accuracy, integrity, and timeliness of data and billing processes that directly impact program funding, compliance, and operations. The position supports multiple teams and requires strong attention to detail, system thinking, and proactive communication.

WORK ENVIRONMENT & PHYSICAL DEMANDS

·         Home or office atmosphere

·         Sitting for extended periods of time

o   Standing desk available at office location if sit/stand option is preferred.

·         Using a variety of office equipment

·         Low noise level