Biller II
Priority Dispatch
- Biller IISioux Falls Arway - Sioux Falls, SD 57106## Description**Position Summary**This position supports our Mission – To expand access to compassionate, high-quality mental health care.The Biller II position takes on expanded regional ownership as the primary liaison between patients in their assigned region and the Billing Team. In addition to performing the day-to-day billing functions shared with the Biller I role, the Biller II serves as the first point of contact for patient billing questions, concerns, and complaints — conducting research to identify resolutions, communicating outcomes directly to patients, and escalating unresolved issues to the Billing Lead or Director of RCM. This role requires strong billing knowledge, sound judgment, and the interpersonal skills to represent Turnwell with professionalism and empathy in every patient interaction.## Qualifications**Core Responsibilities****Core Billing Operations*** Post insurance and patient payments, adjustments, and reconcile remittance advice (EOBs/ERAs) accurately and in a timely manner.* Review and work claim rejections and basic denials, applying corrections within established procedures and escalating complex issues as appropriate.* Assist with follow-up on outstanding accounts receivable balances as assigned by the Billing Lead or Director of RCM.* Support insurance eligibility verification and coordination of benefits as directed.* Maintain accurate, complete billing records in the Electronic Health Record (EHR) and billing systems in accordance with departmental standards.**Regional Patient Liaison*** Serve as the designated Billing Team liaison for patients in an assigned regional territory, acting as the primary point of contact for billing-related questions, concerns, and complaints.* Receive and review incoming patient billing inquiries from the assigned region, gathering all relevant account information to fully understand the issue before responding.* Conduct thorough research into patient accounts, claim history, insurance records, and payment activity to identify the root cause of billing discrepancies, errors, or concerns.* Communicate directly with patients to provide clear, accurate, and empathetic explanations of billing activity, insurance decisions, account balances, and available resolution options.* Coordinate internally with the Billing Team, front office staff, and clinical providers as needed to gather information and facilitate resolution on behalf of the patient.* Document all patient contacts, research steps, and resolution actions in the EHR and billing system, maintaining a complete and auditable record of each case.**Escalation & Issue Resolution*** Attempt to resolve patient billing concerns at the first point of contact whenever possible, applying billing knowledge and available account data to reach a fair and accurate resolution.* Identify cases that require additional authority, clinical review, payer involvement, or policy exceptions, and escalate promptly to the Billing Lead or Director of RCM with a clear summary of the issue, research conducted and recommended next steps.* Follow up on escalated cases to ensure resolution is achieved and communicate the outcome back to the patient in a timely manner.* Track escalation patterns and recurring patient concerns in the assigned region, sharing observations with the Billing Lead to inform process and communication improvements.**Compliance & Documentation*** Adhere to all HIPAA regulations and organizational policies governing patient privacy, data handling, and billing documentation.* Follow established billing procedures and compliance guidelines; escalate questions or policy gaps to the supervisor.* Participate in team meetings, training sessions, and process improvement initiatives as directed by the Billing Lead or Director of RCM.**Qualifications****Required*** High school diploma or GED required; associate's degree in healthcare administration, medical billing, or a related field preferred.* Minimum 2–3 years of medical billing experience, with demonstrated competence in claims submission, payment posting, and denial follow-up.* Working knowledge of CPT, ICD-10, and HCPCS codes and insurance claims processing for behavioral health or medical services.* Experience working with Medicaid, Medicare, and/or commercial insurance payers.* Proficiency with EHR and medical billing software systems.* Excellent verbal and written communication skills; ability to explain billing concepts clearly and compassionately to patients.* Strong research and problem-solving skills; ability to investigate account issues and identify accurate, fair resolutions.* Highly organized with the ability to manage a caseload of patient inquiries alongside ongoing billing responsibilities.* Commitment to HIPAA compliance and patient confidentiality.**Preferred*** Experience in behavioral health, psychiatry, or a specialty mental health billing environment.* Prior experience in a patient-facing billing advocacy, customer service, or account resolution role.* Certified Professional Biller (CPB) or equivalent certification.* Familiarity with specialty service line billing for TMS, Spravato, IV Ketamine, or IOP.**Core Competencies**| | || --- | --- || Medical Billing & Claims Management | Patient Communication & Advocacy || Research & Issue Resolution | Escalation Judgment || Regional Liaison Ownership | Attention to Detail & Accuracy || HIPAA Compliance | Cross-Functional Collaboration || Time Management & Prioritization | Empathy & Professionalism |**Work Environment & Physical Requirements**This position is primarily office- or clinic-based and involves extended periods of computer use, telephone communication with patients and payers, and billing system documentation. The Biller II may support multiple Turnwell Mental Health Network locations within their assigned region as needed. Occasional lifting of up to 20 pounds may be required. This role requires regular direct communication with patients navigating billing concerns; a calm, professional, and empathetic approach is essential at all times.**Compensation & Benefits**Turnwell Mental Health Network offers a competitive salary commensurate with experience. Benefits eligibility is determined based on employment status and organizational policy. Details will be provided during the recruitment process.**About Turnwell Mental Health Network**Turnwell Mental Health Network is a comprehensive mental health practice dedicated to providing compassionate, evidence-based care to individuals across all stages of their mental health journey. Our services include general psychiatric evaluation and medication management, individual and group therapy, Transcranial Magnetic Stimulation (TMS), Spravato (esketamine), IV Ketamine therapy, and Intensive Outpatient Programming (IOP). We are committed to breaking barriers to mental health care and empowering our communities through innovation, clinical excellence, and compassion.
- J-18808-Ljbffr Priority Dispatch
Vacancy posted 4 days ago
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