Billing Specialist (Medical Industry)

Job Description: Behavioral Health Billing Specialist

Location: Remote – Full-Time; must be a US citizen residing in the US

Key Responsibilities:

·         Accurately prepare and submit claims for various services rendered across all facilities.

·         Regularly review patient financials to assure claims are processed accordingly.

·         Analyze and address claim denials, rejections, and underpayments, and take corrective actions to resolve issues.

·         Generate claims for all complete, accurately documented encounters.

·         Reviews clinical documentation against claim information prior to claim submission. Identifies documentation discrepancies and/or deficiencies and reports them accordingly for correction in accordance with NLM’s clinical documentation integrity and compliance standards.

·         Queries supervisor with any questions or uncertainties.

·         Verifies and updates insurance information and/or patient demographic information as required to ensure claims submitted are clean, error-free claims.

·         Reviews providers’ selection of CPT and ICD-10 codes for accuracy to assure clean claim submission.

·         Ensures billing compliance with federal, state, and payer-specific guidelines, including Medicaid, Medicare, and commercial insurance.

·         Utilize appropriate ICD-10-CM, CPT, and HCPCS codes for services provided.

·         Communicate and collaborate with the revenue cycle team to ensure proper coding and documentation for all services rendered. Our RCM team strives to provide staff with the education, materials, and tools necessary to carry out their roles effectively and efficiently.

·         Stay up to date with regulatory changes in billing practices, payer policies, state and federal laws, and reimbursement methodologies, particularly as they pertain to addiction treatment and integrated services.

·         Utilize InSync’s reports, dashboards, and tools to analyze and track billing data, claims productivity, and monitor the revenue cycle from claim generation to claim payment, improving processes where needed.

·         Provide support in auditing and quality assurance processes to ensure billing accuracy and data integrity.

·         Work closely with RCM staff to resolve billing issues and optimize revenue cycle processes.

·         Contributes to the development and implementation of best practices for billing processes, working to streamline workflows and increase efficiency within the billing department.

·         Assist with relevant projects and assignments, as requested.

Qualifications:

·         2+ years of outpatient professional behavioral health billing experience; MAT and OBOT/OBAT service billing (fee-for-service and bundle charges) experience is preferred but not required

·         Certified Professional Biller (CPB), Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) preferred but not required

·         High school diploma or equivalent; additional education in medical billing, coding, or healthcare administration is a plus.

·         Excellent analytical, problem-solving, and communication skills.

·         Ability to work independently and collaboratively in a team environment.

·         Detail-oriented with a high degree of accuracy in data entry and financial analysis.

·         Proficiency with EMR systems and billing/practice management software required

·         Knowledge and experience with InSync EMR/PM a PLUS

·         Flexible and easily adaptable to change

Benefits

• Medical, Vision, Dental
• PTO
• 401k
• EAP
• Travel Assistance
• Weekends Closed