Medical Billing & Authorization Specialist

Location: Lakeville, MN
Employment Type: Part-Time or Full-Time
Schedule: Flexible, Monday–Friday
Compensation: Based on experience


Gateway Health Services Inc. is seeking an experienced, detail-oriented Medical Billing & Authorization Specialist to support our growing behavioral health programs, including Intensive Residential Treatment Services and Adult Mental Health Targeted Case Management.


The ideal candidate will have experience with Minnesota Medical Assistance, Medicaid managed care organizations, behavioral health billing, prior authorizations, and insurance claims management.


This position is responsible for ensuring timely and accurate claims submission, managing service authorizations, resolving denied or rejected claims, and following up on outstanding reimbursements.


We are seeking a dependable, organized, and proactive individual who can independently manage billing responsibilities while collaborating with our clinical and administrative teams.


Key Responsibilities:


Insurance Authorizations & Eligibility

• Prepare, submit, and track initial and continued-stay authorizations for IRTS services.
• Monitor authorization expiration dates and coordinate timely renewal submissions.
• Verify client insurance eligibility, coverage, and authorization requirements.
• Communicate with insurance providers, utilization management teams, and clinical staff to obtain necessary documentation.
• Maintain accurate authorization records and tracking systems.
  
  

Medical Billing & Claims Management

• Prepare, review, and submit accurate claims for IRTS and AMH-TCM services.
• Ensure claims are submitted within payer filing deadlines.
• Review billing documentation for completeness, accuracy, and compliance with payer requirements.
• Monitor claims for acceptance, processing, payment, rejection, and denial.
• Identify and correct billing errors, including coding, authorization, eligibility, and documentation-related issues.
• Submit corrected claims and appeals as appropriate.
• Post and reconcile insurance payments and adjustments as assigned.
  
  

Denial Management & Accounts Receivable

• Investigate denied, rejected, underpaid, and unpaid claims.
• Contact insurance companies to determine claim status and resolve payment issues.
• Prepare and submit reconsiderations, appeals, and supporting documentation.
• Monitor outstanding accounts receivable and follow up on aging claims.
• Identify recurring denial trends and recommend improvements to billing processes.
• Maintain detailed records of claim follow-up activities and resolutions.
  
  

Compliance & Reporting

• Maintain knowledge of Minnesota DHS billing requirements, Medical Assistance policies, and applicable payer guidelines.
• Ensure billing practices comply with state and federal regulations, payer contracts, and organizational policies.
• Collaborate with clinical and administrative staff to address documentation deficiencies affecting billing.
• Prepare regular billing reports, including submitted claims, outstanding authorizations, denials, and accounts receivable.
• Assist with billing audits, reconciliation, and process improvements.
• Maintain confidentiality of client information in accordance with HIPAA requirements.
  
  

Required Qualifications

• Minimum of 2 years of medical billing, insurance claims, or revenue cycle management experience.
• Experience with Medicaid/Medical Assistance billing and managed care organizations.
• Knowledge of insurance authorization processes, claim denials, appeals, and reimbursement procedures.
• Experience working with electronic health records (EHR) and billing systems.
• Strong organizational skills, attention to detail, and ability to manage multiple deadlines.
• Ability to communicate professionally with insurance companies, clinical staff, and administrative personnel.
• Ability to work independently and take ownership of assigned billing responsibilities.
  
  

Preferred Qualifications

• Previous billing experience in behavioral health, mental health, or residential treatment settings.
• Familiarity with Minnesota DHS requirements for IRTS and AMH-TCM services.
• Experience working with Minnesota Medicaid managed care plans, including HealthPartners, UCare, Blue Plus, and other applicable payers.
• Experience with InSync/Qualifacts or similar EHR systems.
• Knowledge of claim correction procedures, denial appeals, authorization tracking, and accounts receivable management.
• Medical billing or coding certification (CPC, CPB, or equivalent) is a plus but not required.
  
  

Work Schedule & Employment Options: 
We are open to both part-time and full-time candidates based on experience, qualifications, and organizational needs.


The ideal candidate will be able to independently manage assigned billing responsibilities, meet submission deadlines, and maintain consistent communication with program leadership.

 Pay: $25.00–$30.00 per hour, depending on experience.