Billing Specialist - Remote

Billing Specialist – Full-Time and Part-Time

 Description:

The Billing Specialist is responsible for the billing process for behavioral and mental health services, ensuring accurate and timely submission of claims to insurance companies, following up on outstanding payments, resolving billing discrepancies, and maintaining compliance with healthcare regulations, all while specializing in the unique coding and billing guidelines related to behavioral health services.

Billing Specialist Responsibilities:

• Accurately submit electronic claims to insurance payers.
• Reviews and addresses all aging AR, denials, and rejections accurately and efficiently.
• Review claims for accuracy, identifying potential errors, and correcting issues before submission to maximize reimbursement. 
• Investigates and appeals denied claims, communicating with insurance companies to resolve billing discrepancies. 
• Utilizes all available payor resources to follow up and expedite claim inquiries, appeals, disputes, and escalations.
• Collaborates closely with team members to identify and report on payor trends, denials, billing issues/discrepancies, and areas for improvement.
• Ensure that all claims are worked on in a timely manner and documented accordingly.
• Maintains current knowledge of insurance requirements and an understanding of the changing demands of federal regulations and organizational requirements.
• Adheres to all processes and workflows.
• Responds to all billing inquiries from patients and internal teams.
• Respectful, courteous and professional in all forms of communication and follows the facility's service communication protocol in all interactions.

Qualifications:

• Working knowledge of Microsoft Office (Word, Excel, Outlook, etc.) and insurance portals (BCBS, Aetna, UHC, Availity, MD Medicaid EVS, Carelon, etc.).
• Experience using INSYNC EHR is preferred.
• Understands the nuances of different insurance types.
• Ability to analyze and interpret explanations of benefits from all payors.
• Proven track record for improving process efficiencies and solving problems.
• Detail-oriented and organized.
• Excellent written and verbal communication skills.
• Strong problem solving and analytical skills that demonstrate resourcefulness and initiatives.
• Ability to multitask effectively.
• Ability to strategically, logically, and realistically analyze, evaluate and develop solutions to the agency’s business needs.
• Ability to effectively build relationships with individuals of all ages, ethnicity, education, and work experience.
• Understands and maintains confidentiality and all regulations regarding HIPAA and 42 CFR Part 2.
• Exhibits professionalism and a friendly demeanor and is a positive representative of the company over the phone and in person.
• Comfort with computers and technology, especially Excel.
• Reliable, ethical, and honest work ethic.
• Knowledge and experience with provider credentialing is a plus.
• Carelon and commercial authorization experience strongly preferred.
• Must be a U.S. citizen or permanent resident.

Experience and Education:

• Minimum of a High School Diploma or equivalent is required
• Minimum of 2 years’ experience in medical billing is required
• Working knowledge of medical coding such as CPT and ICD-10 are required
• Experience in the mental or behavioral health field preferred
• Basic knowledge of Excel is required
• Experience with payer portals strongly preferred
• Strong knowledge of different insurance types is required.