Billing Specialist
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AI Summary
Manage accounts receivable and insurance billing processes specifically for behavioral health services. Ensure timely reimbursement by submitting claims and resolving denied or rejected submissions.
The Billing Specialist is responsible for managing accounts receivable, insurance billing, claims follow-up, and revenue cycle processes specific to behavioral health services. This role ensures timely reimbursement, accurate billing submissions, and compliance with Medicaid, commercial insurance, and local regulatory requirements
Key Responsibilities:
- Submit and monitor claims for mental health and SUD services (Medicaid, MCO's, commercial payers)
- Review and correct denied or rejected claims
- Reconcile accounts
- Track outstanding AR balances and aging reports
- Follow up with insurance companies regarding unpaid claims
- Verify authorizations and ensure services billed align with approved units
- Collaborate with Clinical Director and Managers to resolve documentation issues
- Maintain compliance with Maryland and Medical billing guidelines
- Assist with audits and provide documentation as requested
- Submit billing for the agency
Preferred Experience:
- Experience working in a community-based behavioral health agency
- Knowledge of authorization management and service unit tracking
- Experience with compliance audits and corrective billing processes
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