Full-Time Billing and Accounts Receivable Specialist

Qualifications

• High school diploma or GED required.
• Associate degree or certification in medical billing, medical coding, health information management, or a related field strongly preferred.
• Two to three years of experience in medical billing, claims follow-up, accounts receivable, or revenue cycle operations required, preferably in a behavioral health inpatient, mental health, or acute care setting.
• Experience with accounts receivable follow-up, payer denials, claim corrections, payment posting, and insurance billing strongly preferred.
• Knowledge of Medicaid and commercial insurance requirements preferred.
• Knowledge of behavioral health inpatient billing, insurance requirements, and payer processes strongly preferred.
• Willingness to learn authorization and utilization review processes and support related tasks as needed.
• Strong customer service skills and professional phone manner.
• Excellent time management, organization, and follow-through.
• Ability to work through complex insurance and billing issues in partnership with internal care team members.
• Ability to work independently with minimal supervision.
• Ability to maintain confidentiality and professionalism at all times.
• Reliable transportation and ability to work on-site required.
• Current CPR and First Aid certification required or ability to complete certification upon hiring decision.

Responsibilities

• Submit claims and reimbursement requests to Medicaid, commercial insurance, and other applicable payers.
• Accurately enter charges, process claims, post payments, and maintain timely billing workflows.
• Monitor accounts receivable and follow up on unpaid claims.
• Review payer denials, rejected claims, and billing discrepancies.
• Correct and resubmit claims as needed.
• Post insurance payments, patient payments, adjustments, and other account activity accurately.
• Triage incoming billing and insurance communications received by email, mail, and fax.
• Route correspondence, payer requests, EOBs, remittance documents, and other communications to the appropriate team members or workflows.
• Work with patients and families regarding billing questions, account balances, self-pay arrangements, and payment plans.
• Initiate private-pay follow-up and collections processes according to company policy.
• Maintain accurate, confidential, and organized billing documentation.
• Adjust patient accounts accurately and appropriately according to company policies and established criteria.
• Learn authorization and utilization review support processes and assist with related tasks as needed.