Billing Specialist

Our client, a leading provider of behavioral health and substance use disorder services, is hiring a Billing Specialist to ensure accurate and efficient management of billing, eligibility verification, and claims processing. This key role supports clinical operations by verifying client benefits, coordinating pre-authorization requirements, and assisting with financial counseling to optimize patient care and revenue cycle workflows.

Responsibilities:

• Determine initial client eligibility and benefits, including pre-authorization or pre-certification requirements under benefit plans for substance use disorder services.
• Input authorization tracking data into Insync and notify clinical leadership of pre-auth or admission needs before client appointments.
• Prepare and distribute financial agreements, ensuring clients understand their financial responsibility; meet with eligible clients for financial counseling and sliding scale agreements.
• Review daily eligibility batch reports, contacting ineligible clients to update insurance information, facilitate recertification, or manage out-of-pocket payments.
• Confirm appointment eligibility prior to service, notify front desk staff and clients of any ineligibility, and ensure appropriate documentation.
• Verify provider billing codes, review service charges for accuracy, and correct any coding issues promptly.
• Monitor billing submissions, ensuring services are billed within 48 hours of delivery, and address denied or unpaid claims through coordination with billing software and clinical staff.
• Generate and analyze billing and accounts receivable reports, assist with collections, and maintain accurate financial records.
• Support clinical and administrative staff with billing or insurance-related inquiries and serve as a resource for billing best practices.
• Manage the assessment tracker to monitor appointment no-shows, cancellations, and rescheduling activities.

Requirements:

• Associate's degree or higher in health administration, medical billing, or related field.
• Minimum of 2 years’ experience in healthcare billing and eligibility verification.
• Proven experience in medical or behavioral health billing and coding, with familiarity in insurance verification and claims processing.
• Strong knowledge of billing software, particularly Insync, and proficiency with Medicaid, insurance benefits, and pre-authorization procedures.
• Excellent organizational skills with the ability to multitask and prioritize in a fast-paced environment.
• Effective communication skills to liaise with clients, clinical staff, and insurance providers.
• Attention to detail and accuracy in reviewing charges, coding, and documentation.
• Ability to work on-site, with availability to coordinate with clinical and administrative teams.
• Familiarity with confidentiality regulations and compliance standards related to healthcare information.

Nice to Have Skills:

• Experience working with Medicaid and other government-funded programs.
• Basic understanding of behavioral health services and clinical workflows.
• Certification in medical billing or coding (e.g., CPC, CPRS).
• Bilingual abilities to serve diverse patient populations.

If you are meticulous, customer-focused, and eager to contribute to a mission-driven organization, we encourage you to apply today. Join a dedicated team committed to improving lives through outstanding administrative and clinical collaboration.

Salary: The posted range is not a guarantee. The actual salary will be based on qualifications, experience, and education and could fall outside of this range. Contact us for more information.
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