Sr. Billing Specialist (Remote)

About the role

We are seeking an experienced Billing Specialist to manage assigned Pre-Bill functions on the Revenue Cycle Management team. As a Sr. Billing Specialist you will tackle complex billing challenges and drive operational excellence.

Responsibilities

• Investigate claim rejections
• Navigate evolving payer requirements
• Ensure complex claims are prioritized and resolved accurately
• Provide leadership and guidance to our offshore teams
• Monitor automated workflows to ensure operational efficiency
• Partner with cross-functional teams to analyze operational trends, identify key opportunities to optimize workflows and claim outcomes

Requirements

• 3+ years of Medical Billing experience
• Proven ability to improve and optimize processes, leveraging tools such as Salesforce, AMD, payer portals (e.g., Availity), Google Suite/Microsoft Office (including Excel/Google Sheets), etc. to drive optimization
• Comprehensive understanding of the end-to-end claims lifecycle and front-end revenue integrity with comprehensive knowledge of front-end claim edits, rejection codes, and payer-specific billing requirements
• Critical Thinking: Evaluating complex cases, identifying solutions, and making informed decisions

Preferred Qualifications

• Previous Mental Health or Behavioral Health Billing and Collections experience
• Basic-Intermediate level Excel (ex: Data Formatting, basic charts, pivot tables)
• Proficiency with electronic health record (EHR) systems, billing software, such as AdvancedMD
• Ability to multitask, prioritize workloads, and meet tight deadlines in a fast-paced environment
• Organizational Skills: Managing high-volume pre-bill work queues, documentation, and tracking front-end claim statuses with meticulous attention to detail
• 1+ years partnering with and/or leading Offshore Teams, preferred, but not required