Billing Specialist (160)

Job ID: 160 Shift: 20 hours weekly, flexible schedule As a team, the mission of Lifeworks is to provide advocacy, empowerment, and opportunity to those that we serve. As a member of our team, we are all here to support you as we provide creative opportunities and services to adults with developmental and intellectual disabilities. Lifeworks isn't just a job; it is an opportunity for a fulfilling career with a purpose. We offer competitive pay & excellent benefits in a rewarding and supportive environment. Billing Specialist Harbor Counseling is seeking a detail-oriented, part-time Billing Specialist to support billing operations for our outpatient mental health clinic. This role is responsible for helping ensure accurate, timely, and compliant billing processes, with a focus on insurance verification, denial resolution, billing data maintenance, reporting, credentialing support, and coordination with clinical and administrative teams. The Billing Specialist will work closely with the billing department, Clinical Director, clinicians, and administrative staff to resolve denied claims, clarify billing requirements, support process improvements, and maintain accurate client insurance and billing information in electronic medical record system, Ehana. This position also supports the development of billing standard operating procedures and provides guidance to program staff as needed. The ideal candidate is organized, collaborative, and comfortable working across billing, clinical, and administrative functions in a regulated healthcare environment. This position must comply with all applicable Human Rights, DPPC, Department of Developmental Services, Division of Medical Assistance, payer, funding, and Lifeworks policies and regulations. Review, research, and resolve denied or rejected insurance claims, with priority given to claims approaching timely filing limits. Support billing operations for an outpatient mental health clinic serving individuals with intellectual and developmental disabilities. Verify insurance coverage for new referrals, with emphasis on Medicare, MassHealth/Medicaid, and other Massachusetts payer requirements. Confirm clinician eligibility, credentialing status, authorization requirements, and payer rules before client assignment or billing submission. Enter, update, and maintain accurate billing, demographic, authorization, and insurance information in Ehana. Run and monitor billing reports from Ehana, payers, clearinghouses, and other vendor systems to identify trends, errors, denials, and missed revenue opportunities. Collaborate with the billing department, Clinical Director, clinicians, administrative staff, and families when appropriate to clarify coverage, billing requirements, claim issues, and loss-of-coverage concerns. Assist with credentialing applications, payer enrollments, revalidations, and related follow-up needed to support clinic growth and provider participation. Help develop, document, and improve standard operating procedures for billing, insurance verification, claim follow-up, denial management, and payer communication. Provide billing-related training, guidance, and support to clinicians and program staff to promote accurate documentation, timely billing, and compliance with payer requirements. Participate in regular denial review and billing performance meetings to identify root causes, recommend process improvements, and track action plans. Work with leadership and billing partners to support scalable billing practices as the agency expands services, payer relationships, and outpatient clinic capacity. Maintain confidentiality and comply with all applicable Human Rights, DPPC, DDS, MassHealth/Medicaid, Medicare, payer, funding, HIPAA, and Lifeworks requirements. Perform other duties as assigned. Requirements High School Diploma or GED required; associate degree or coursework in accounting, business administration, healthcare administration, medical billing, or a related field preferred. Minimum of five years of related experience in billing, accounting, claims processing, revenue cycle, or healthcare administrative support required; experience in outpatient behavioral health or mental health billing strongly preferred. Working knowledge of Massachusetts insurance processes, including MassHealth/Medicaid, Medicare, managed care plans, eligibility verification, claim submission, denial follow-up, and timely filing requirements, preferred. Experience supporting billing functions in a clinical or human services setting serving individuals with intellectual and developmental disabilities is preferred. Strong computer skills required, including proficiency with Microsoft Office Suite, especially Excel, Word, and PowerPoint. Experience with spreadsheet tracking, database management, billing reports, and electronic health record or billing systems required. CPR, First Aid certification, Medical Administration Must be able to pass Fingerprint background check, CORI, DPPC and Driving background checks Valid Driver's License in the state residing Excellent verbal and written communication skills Excellent Compensation Package 403(b) matching up to 3% $2,000.00 Staff Retention Bonus after 1 year** Health Insurance with 2 plan choices and a 75% employer contribution. Benefits available upon hire: Dental, Vision and Short-Term disability 4.4 weeks of Paid Time Off in your first year of employment Long-Term Disability insurance & Life Insurance free for employees Flexible spending account Lifeworks, Inc. believes diversity strengthens the value of our workplace and communities. We are proud to be an Equal Opportunity Employer. Disclaimer: This job profile identifies the general duties and minimum level of skills required to perform this job. It is not intended to represent a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned. The employee can be responsible for all other duties as assigned by supervisor. Employment at Lifeworks is on an at-will basis. This means that the employee or employer may terminate employment at any time, for any reason or for no reason and with or without prior notice. Nothing in this job description or employee handbook creates an employment agreement, express or implied, or any other agreement between an employee and Lifeworks. #J-18808-Ljbffr Lifeworks, Inc.