Medical Biller

Position Overview

Americare Behavioral Health, LLC is seeking an organized, dependable, and detail-oriented Medical Billing Department Staff member to support the daily billing and financial operations of its behavioral health clinic. This is an in-office position responsible for coordinating with the agency's outsourced medical billing company, monitoring billing activities, preparing financial and billing reports, managing patient copays and outstanding balances, and ensuring that billing-related tasks are completed accurately and on time.

The agency utilizes an outsourced billing company to handle insurance claim submissions. The primary responsibility of the in-house Billing Department Staff member is to provide the outsourced biller with the necessary documentation, information, and administrative assistance to facilitate accurate and timely claim processing. The employee will also monitor billing progress, follow up on outstanding issues, review billing-related reports, and coordinate with clinical and administrative personnel to resolve discrepancies.

In addition, this position is responsible for preparing and submitting copay and outstanding balance reports, collecting patient copays and balances, issuing statements of account to clients, monitoring payments, and maintaining accurate billing and collection records. The role requires regular communication with clients regarding outstanding balances and coordination with the appropriate staff to address billing concerns.

The ideal candidate possesses a Medical Billing Certificate, has experience working in a behavioral health clinic, and demonstrates strong organizational, communication, and problem-solving skills. The candidate must be comfortable handling confidential patient and financial information, managing multiple responsibilities, and ensuring that billing operations run efficiently while supporting the clinic's revenue cycle and financial accountability.

Key Responsibilities

1. Outsourced Billing Coordination and Support

• Serve as the primary in-house point of contact for the outsourced medical billing company regarding day-to-day billing operations.
• Provide requested clinical documentation, patient information, insurance details, authorization records, and other supporting materials needed for claim processing.
• Coordinate with providers and administrative staff to obtain missing notes, signatures, treatment plans, authorizations, or other required documentation.
• Respond promptly to requests from the outsourced biller and follow up on outstanding information or unresolved issues.
• Monitor the status of billing-related tasks and coordinate with the outsourced biller to address rejected claims, denials, missing information, and other billing discrepancies.
• Review reports provided by the outsourced biller and identify missing information, inconsistencies, or items requiring clarification.
• Escalate recurring billing problems, delayed follow-ups, and unresolved discrepancies to the appropriate supervisor or management.
• Maintain organized records of communications, outstanding requests, and completed follow-up tasks.

2. Copay and Patient Balance Management

• Monitor patient copays, deductibles, coinsurance, and other outstanding balances in accordance with the clinic's billing policies and applicable payer requirements.
• Generate and maintain accurate reports of copays and outstanding patient balances.
• Identify clients with unpaid copays, overdue balances, or unresolved payment discrepancies.
• Coordinate with front-desk and administrative staff to ensure copays are collected at the appropriate time.
• Collect and process patient copays and outstanding balances through approved payment methods and procedures.
• Record payments accurately and maintain supporting documentation for all transactions.
• Follow up with clients regarding unpaid balances and communicate payment expectations professionally.
• Refer disputed balances, financial hardship concerns, and other complex billing matters to the appropriate supervisor.
• Reconcile collection records against payment reports and billing system entries to ensure accuracy.

3. Statements of Account and Client Billing Communications

• Prepare and send statements of account to clients with outstanding balances.
• Ensure statements accurately reflect charges, payments received, adjustments, and remaining balances.
• Establish and maintain a consistent schedule for issuing statements and following up on unpaid accounts.
• Respond to routine client inquiries regarding statements, copays, balances, and payment records.
• Investigate discrepancies reported by clients and coordinate corrections with the outsourced biller or appropriate internal staff.
• Maintain records of statements issued, client communications, payment arrangements, and collection follow-ups.
• Protect confidential patient information when preparing and distributing billing statements.

4. Billing Reports and Financial Tracking

• Prepare and submit regular copay collection reports, outstanding balance reports, and other billing-related reports required by management.
• Maintain updated spreadsheets and tracking logs for client balances, payments collected, unpaid copays, and outstanding accounts.
• Monitor collection activity and identify accounts requiring additional follow-up.
• Review billing and payment information to identify inconsistencies, duplicate entries, missing payments, or other discrepancies.
• Reconcile collected payments against receipts, billing records, and applicable system reports.
• Track outstanding items and ensure reports are submitted accurately and within established deadlines.
• Provide management with clear and timely updates regarding collection activity, unresolved balances, and billing-related concerns.

5. Payment Processing and Reconciliation

• Receive and process client payments in accordance with agency procedures.
• Issue or coordinate appropriate payment receipts and maintain accurate transaction records.
• Verify that collected payments are properly recorded and reflected in the relevant billing or financial system.
• Review payment records for discrepancies and coordinate corrections when necessary.
• Assist with reconciling copay collections, client balance payments, and other billing-related transactions.
• Safeguard cash, checks, payment information, and other financial records in accordance with agency policies.

6. Insurance and Billing Documentation Support

• Assist in verifying insurance eligibility, coverage information, and authorization status when needed to support billing operations.
• Review available billing documentation to identify missing information or discrepancies that may affect claim processing.
• Coordinate with providers and administrative staff to obtain required documentation before forwarding it to the outsourced biller.
• Track missing or incomplete documentation and follow up until resolved.
• Assist in reviewing billing reports and researching questions related to charges, payments, adjustments, and outstanding claims.
• Ensure billing-related records are organized, complete, and readily available for authorized review.

7. Client Account Follow-Up and Issue Resolution

• Contact clients regarding outstanding copays, unpaid balances, and statements of account in a professional and respectful manner.
• Maintain a log of client contact attempts, payment commitments, disputes, and follow-up actions.
• Coordinate with the front desk and administrative team to clarify payment responsibilities and resolve routine account questions.
• Refer complex disputes, potential billing errors, financial hardship requests, and complaints to the appropriate supervisor.
• Follow agency procedures regarding collections, payment arrangements, refunds, and account adjustments.
• Maintain professionalism and confidentiality in all client billing communications.

8. Records Management, Confidentiality, and Compliance

• Maintain accurate and organized billing records, payment logs, statements, receipts, correspondence, and reports.
• Protect confidential patient, insurance, and financial information in accordance with HIPAA, applicable privacy requirements, and agency policies.
• Follow established procedures for payment collection, financial documentation, and billing record maintenance.
• Assist with internal audits, financial reviews, and requests for supporting billing documentation.
• Report suspected billing errors, discrepancies, irregularities, or potential compliance concerns to the appropriate supervisor.
• Ensure records are current, complete, and readily available for authorized review.

9. General Billing Department Administration

• Maintain organized billing trackers, spreadsheets, client account records, and follow-up schedules.
• Coordinate with clinical, administrative, and finance personnel to resolve billing and collection issues.
• Monitor assigned tasks and deadlines to ensure that billing department responsibilities are completed consistently.
• Recommend improvements to billing workflows, reporting procedures, and collection tracking.
• Perform other related billing, collections, reporting, and administrative duties as assigned.

Required Qualifications

• High school diploma or equivalent; an associate degree in Medical Billing, Healthcare Administration, or a related field is an advantage.
• Must possess a Medical Billing Certificate from a recognized training program or accredited institution.
• Minimum of one to two years of experience working in a behavioral health clinic, preferably in medical billing, patient accounts, collections, or billing administration.
• Basic understanding of medical billing procedures, insurance claims, copays, deductibles, coinsurance, patient balances, and reimbursement processes.
• Familiarity with preparing statements of account, tracking payments, reconciling balances, and maintaining collection records.
• Proficiency in Microsoft Office applications, particularly Excel, Word, and Outlook.
• Strong attention to detail and accuracy in data entry, payment recording, report preparation, and account reconciliation.
• Strong organizational and time-management skills, with the ability to manage multiple accounts, follow-up tasks, and reporting deadlines.
• Effective written and verbal communication skills for interacting with clients, providers, administrative staff, and outsourced billing personnel.
• Ability to handle payment inquiries and collection follow-ups professionally and respectfully.
• Ability to maintain the confidentiality and security of patient, insurance, and financial information in accordance with HIPAA and applicable privacy requirements.
• Ability to work independently in an in-office setting, follow established procedures, and collaborate effectively with internal and external billing personnel.

Preferred Qualifications

• Associate degree or additional relevant certification in Medical Billing and Coding, Healthcare Administration, or a related field.
• Two or more years of experience in the billing department of a behavioral health clinic or mental health practice.
• Experience coordinating with outsourced medical billing companies or third-party revenue cycle management providers.
• Experience preparing copay reports, accounts receivable reports, statements of account, and outstanding balance summaries.
• Experience collecting patient payments, reconciling transactions, and following up on overdue balances.
• Familiarity with outpatient behavioral health services, psychotherapy billing, psychiatric services, and related documentation requirements.
• Familiarity with MassHealth, Medicare, Medicaid, and commercial insurance requirements applicable to the clinic's services.
• Knowledge of CPT, ICD-10-CM, and other applicable medical billing and coding standards.
• Experience using electronic health records (EHRs), practice management systems, billing software, insurance portals, and electronic payment platforms.
• Knowledge of HIPAA privacy and security requirements and applicable healthcare billing compliance standards.
• Experience identifying payment discrepancies, investigating account issues, and recommending improvements to billing and collection procedures.
• Strong analytical and problem-solving skills, particularly in reviewing financial reports and monitoring outstanding patient accounts.

Core Performance Expectations

• Provide timely and effective support to the outsourced billing company.
• Submit accurate copay, collection, and outstanding balance reports according to established deadlines.
• Ensure statements of account are prepared and distributed consistently and accurately.
• Maintain organized and up-to-date client payment and billing records.
• Follow up on outstanding copays and balances consistently and document collection activities.
• Record payments accurately and promptly identify discrepancies.
• Communicate unresolved billing issues and collection concerns to management.
• Demonstrate professionalism, accountability, confidentiality, and reliability in all billing department activities.

Disclaimer:This job description outlines the general nature and level of work expected for this position. Duties and responsibilities may be modified as necessary to meet the operational needs of Americare Behavioral Health, LLC and applicable regulatory requirements.

Work schedule

• Monday to Friday