Turning Manual Billing Audits Into an Automated Reconciliation Workflow

Project Overview

Are your billing teams still cross-checking claims against service logs by hand — hunting line by line for missing documentation, duplicate claims, and hours discrepancies? At HillsEditor Services, we build automation tools that catch these issues before they become compliance problems, turning a manual audit process into a fast, repeatable workflow.

This tool was built around a real LTSS Maryland billing workflow and validated against a real 294-row Maryland DDA Monthly Authorized Service export — correctly surfacing 3 critical-threshold accounts, 1 source-flagged exception, and 5 billed-vs-entered discrepancies. It ships with fully synthetic sample data, so it can be demonstrated without exposing any real client or member information.

How the Process Works

LTSS Billing Reconciliation and Units Tracking Tool overview graphic showing three steps: automated reconciliation, color-coded reporting, and units tracking dashboard

Automated Claims-to-Log Reconciliation

  • Cross-checks every billing claim against subcontractor service logs automatically
  • Flags missing documentation, duplicate claims, and hours discrepancies
  • Surfaces unbilled services so no revenue is left on the table
  • Removes hours of manual, line-by-line auditing

Color-Coded, Audit-Ready Reporting

  • Outputs a single Excel workbook with Summary, Discrepancies, and Verified tabs
  • Issues sorted worst-first and color-coded by severity (red / amber / blue)
  • Flat table format, ready for direct upload to a SharePoint document library
  • Creates a clean audit trail for every claim reviewed

Real-Time Units Tracking Dashboard

  • Browser-based tracking app built with Streamlit
  • Flags authorized service-unit balances per client as OK / Watch / Critical
  • Surfaces Billed-vs-Entered mismatches and source-flagged exceptions automatically
  • Prepares a review-ready table for manual submission — no automated portal access, ever; a human reviews and submits everything

Ideal For

  • LTSS and waiver-program billing coordinators
  • Subcontractor and service-validation teams
  • Healthcare operations and compliance staff
  • Any organization reconciling claims against service documentation at scale

Let's Automate Your Reconciliation Workflow

If your team is still auditing billing claims by hand, we can help you build a tool that does the first pass automatically — flagging what needs a human look and clearing what doesn't.

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Why Organizations Choose Automated Billing Reconciliation

  • Hours saved on manual, line-by-line claim audits
  • Billing errors caught before submission, not after
  • Clear, color-coded audit trail for every claim
  • SharePoint-ready output — no reformatting required
  • Built with strict data-handling boundaries: no automated submissions, human review required at every step
  • Adaptable to other billing and service-validation workflows beyond LTSS