Social Care Network Billing Specialist

The Ali Forney Center (AFC) protects LGBTQ+ youth from homelessness and helps them build the tools needed to live independently. Founded in 2002, AFC provides housing, healthcare, and educational support to thousands of youth each year. AFC creates an affirming, supportive environment where LGBTQ+ youth can thrive.

The Social Care Network (SCN) Billing Specialist is responsible for preparing, reviewing, submitting, and reconciling monthly SCN billing and reimbursement documentation related to Medicaid 1115 Waiver Health-Related Social Needs (HRSN) services.

The Billing Specialist works closely with program teams to ensure service documentation is accurate, timely, compliant, and properly entered into the SCN IT Platform to support reimbursement for screenings, navigation, nutrition services, housing supports, and enhanced care management activities.

Key Responsibilities

• Prepare and submit monthly billing and reimbursement documentation for SCN-funded services.
• Review service documentation for completeness, compliance, and billing eligibility prior to claim submission.
• Monitor billing activity for screenings, navigation services, enhanced HRSN services, nutrition supports, and housing-related services.
• Track payments, denials, recoupments, corrections, and outstanding claims.
• Coordinate with program staff to resolve missing documentation, incomplete referrals, or billing discrepancies.
• Maintain accurate billing records and reimbursement reports.
• Assist with audits, monitoring reviews, reconciliation processes, and financial reporting.
• Ensure billing activities comply with NYSDOH, OHIP, SCN Operations Manual, Medicaid, and MCO requirements.
• Support data entry and quality assurance activities within the SCN IT Platform.
• Work collaboratively with AFC finance, compliance, and program leadership teams.

• Identify trends, operational inefficiencies, or compliance concerns impacting reimbursement.

• Associate’s or Bachelor’s degree in accounting, healthcare administration, finance, or related field preferred.
• Experience with New York State Medicaid systems or fee-for-service reimbursement strongly preferred.
• Strong attention to detail and organizational skills.
• Ability to interpret billing guidelines and compliance requirements.
• Experience working with electronic health records, care management systems, or billing platforms preferred.
• Proficiency in Microsoft Excel and reporting systems.
• Strong communication and follow-up skills.

Preferred

• Minimum 2 years of experience in Medicaid billing, healthcare reimbursement, social services billing, or managed care operations preferred.

AFC Core Competencies

• Mission alignment and commitment to affirming, youth-centered practice
• Cultural humility and ability to work effectively with diverse LGBTQ+ youth populations
• Trauma-informed, strengths-based approach to service delivery and collaboration
• Clear communication, professionalism, and accountability
• Adaptability, sound judgment, and ability to respond calmly in fast-paced environments

Role-Related Competencies

• Medicaid & SCN Billing Expertise
• Regulatory Compliance
• Billing Accuracy & Documentation
• Revenue Cycle Management
• Quality Assurance
• Data Integrity & Reporting
• Ability to manage
• Attention to detail
• Collaboration across teams and effective relationship-building with participants, partners, and staff
• Problem-solving & prioritization,
• Technology & Systems Proficiency

Thank you for your interest in the Ali Forney Center. Due to the high volume of applications received, only candidates selected for further consideration will be contacted. We encourage you to apply for any positions for which you meet the qualifications .

Ali Forney Center is an equal opportunity employer committed to a workplace where all employees feel respected, supported, and able to thrive. We consider all qualified applicants without regard to race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, veteran status, or any other protected status.