Contract Compliance & Billing Specialist
Department: Operations / Finance
Reports To: CEO
Position Type: Part-Time, 25 hours per week, Non-Exempt (potential to increase to full time in FY28)
Compensation: $30/hour
Location: Hybrid- required in-person at our Phoenix, AZ office one day a week on Mondays, remote balance of time. (Only applicants with an Arizona residence will be considered for this part time staff role.)
Job Summary
We are seeking a detail-oriented, highly organized Contract Compliance & Billing Specialist to join our team. In this role, you will be responsible for managing financial reporting, ensuring compliance with state licensing and grant contracts, and establishing efficient digital infrastructure for expenditure tracking. Additionally, you will play a critical role in building, optimizing, and maintaining our processes and systems for billing Managed Care Organizations (MCOs) for provided services.
Key Roles & Responsibilities
Grant Financial Reporting & Expenditure Tracking
- Prepare and submit accurate monthly financial reports for all active grants in accordance with local, state, and federal guidelines.
- Organize, maintain, and audit digital filing systems to ensure every expenditure is correctly mapped to its corresponding grant source and supporting documentation.
- Track cash flow, monitor grant budget allocations, and collaborate with the Deputy Director of Internal Operations to prevent over- or under-spending.
- Collaborate with the contracted bookkeeper to prepare for and lead financial reviews, audits, and site visits conducted by granting agencies.
Billing & Managed Care (MCO) Operations
- Design, build, and implement standard operating procedures (SOPs) and systems required to bill managed care companies, Medicaid/AHCCCS health plans, and commercial insurers for services rendered.
- Oversee claims processing, credentialing, coding compliance, and reimbursement tracking for managed care billing.
- Troubleshoot billing rejections, denials, and payment delays; implement corrective actions to maximize revenue collection.
- Interface directly with insurance representatives, billing vendors, and internal clinical/administrative staff to resolve complex billing inquiries.
Contract Compliance & State Licensing
- Oversee all grant contract compliance activities to ensure adherence to scope of work, reporting timelines, restricted expenditures and performance deliverables.
- Manage state licensing compliance and regulatory reporting for the Arizona Department of Health Services (ADHS) and the Arizona Health Care Cost Containment System (AHCCCS).
- Maintain a central compliance calendar to track license renewals, grant application deadlines, quarterly/annual reporting, and required compliance training.
- Serve as the primary liaison during state licensing audits, inspections, and compliance surveys.
Qualifications & Skills
Education & Experience
- Education: Bachelor’s degree in Business Administration, Healthcare Administration, Accounting, Finance, or a related field (or equivalent practical experience).
- Experience: 3+ years of experience in healthcare billing, grant management, contract compliance, or regulatory operations.
- Specialized Knowledge: Direct familiarity with Arizona healthcare regulations, specifically AHCCCS Medicaid standards and ADHS licensure requirements, is strongly preferred.
Technical & Core Competencies
- Insurance Billing: Experience setting up or running electronic billing, processing claims, and managing provider credentialing.
- Grant & Financial Management: Solid background in grant accounting, tracking budgets, ensuring contract compliance, and creating financial reports.
- Digital File Organization: Tech-savvy with tools like Google Workspace, plus a knack for keeping files, folders, and documents organized and easy to find.
- Software Skills: Advanced Excel skills (pivot tables, formulas, VLOOKUPs), experience with Quickbooks Online, and at minimum familiarity with a healthcare/EHR billing platform.
- Top-Notch Accuracy: High attention to detail with a strong commitment to financial accuracy and regulatory rules.
Key Performance Indicators (KPIs)
Grant Reporting: 100% on-time submission of monthly financial reports with zero audit findings.
Audit Readiness: Expenditures digitally archived and cross-referenced to grant sources within 5 business days of occurrence.
MCO Billing System: Successful end-to-end launch of managed care billing workflows with <5% initial claim denial rate.
Licensing Compliance: Zero lapses or non-compliance citations across all ADHS and AHCCCS licenses and contracts.
APPLICATION PROCESS
To be considered, please submit the following:
- Resume
- Cover Letter: Briefly describe your relevant experience, skills, and why you are interested in joining the BLOOM365 mission.
Note: Applicants who do not attach a cover letter or fail to complete the required screening assessments will not be considered. BLOOM365 is an equal opportunity employer.
Work Conditions
o Ability to alternate sitting and standing throughout an 8-hour period and sometimes longer.
o Ability to perform all above-mentioned duties with or without accommodations.
EEO
BLOOM365 is an Equal Opportunity Employer and does not discriminate on the basis of race, color, gender identity, sexual orientation, religion, national origin, status, age, or disability.
ABOUT BLOOM365
Mission: Prevent abuse before it starts.
Vision: Safe and healthy relationships for all.
Goal: Uproot abuse in a generation.
Pay: $30.00 per hour
Work Location: Hybrid remote in Phoenix, AZ 85021
