What are the responsibilities and job description for the Medical Billing Specialist position at Exact Billing Solutions?
OUR MISSION
Exact Billing Solutions (EBS) is a unique team of medical billing professionals with a specialty in the substance abuse and mental health fields of healthcare services. We have extensive industry knowledge, an understanding of the specific challenges of this market, and we stand by our commitment to offer outstanding service to our clients. EBS is the oil that brings life to the engines of its partner healthcare companies.
POSITION SUMMARY & PURPOSE
The Medical Billing Specialist is responsible for maintaining and reviewing records of medical documentation for billing purposes.
The principal functions of the position identified shall not be considered as a complete description of all the work requirements and expectations that may be inherent in the position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position.
ESSENTIAL DUTIES & RESPONSIBILITIES
The following are duties and responsibilities that the Medical Billing Specialist shall provide:
- Review and analyze medical records to ensure accurate and timely billing.
- Utilize medical terminology and billing codes (ICD-10, HCPCS, CPT) for claim submission.
- Prepare and submit claims to insurance companies electronically or by mail.
- Collaborate with medical staff to ensure complete and accurate documentation.
- Maintain patient confidentiality and comply with HIPAA guidelines.
- Communicate with insurance carriers to resolve claim issues and improve cash flow.
- Monitor and report key metrics such as cash collections, outstanding claims, denials, and daily census.
- Update patient demographics and insurance information as needed.
- Document claim status and notes in the patient accounting system (CollaborateMD).
- Escalate payer or client claim issues to department leadership.
- Maintain effective communication with leadership to ensure compliance with third-party guidelines.
EDUCATIONAL/SKILL REQUIREMENTS
The Medical Billing Specialist requires a minimum of a(n):
- Associate's degree (preferred).
- 2–3 years of experience in behavioral health out-of-network billing.
- Knowledge and experience with CollaborateMD EMR and billing software.
- Experience with ABA therapy (preferred).
- Proficiency in medical billing software and computer systems.
- Willingness to submit to drug and background screenings.
