PRE-BILLING QUALITY SPECIALIST

Pre-Billing Quality Specialist Position Summary The Pre-Billing Quality Specialist ensures that all billing across IDD (Intellectual and Developmental Disabilities) and BHH (Behavioral Health Home) programs meets payer and regulatory requirements prior to claim submission. This role verifies that all services are fully supported by accurate documentation, appropriate authorizations, and correct utilization. The Specialist proactively identifies and resolves issues that may delay or prevent billing, working closely with Program teams and Revenue Cycle Management (RCM) to ensure timely and accurate reimbursement. Key Responsibilities Pre-Billing Verification • Review service documentation to ensure compliance with payer-specific billing requirements • Verify completion of all pre-billing steps, including: • Documentation completion • Service entry accuracy • Authorization validation • Unit totals • Confirm required elements such as: • Signatures • Timelines • Service codes and modif