Billing Specialist

Our client, a leading provider of behavioral health and substance use disorder services, is hiring a Billing Specialist to ensure accurate and efficient management of billing, eligibility verification, and claims processing. This key role supports clinical operations by verifying client benefits, coordinating pre-authorization requirements, and assisting with financial counseling to optimize patient care and revenue cycle workflows. Responsibilities: Determine initial client eligibility and benefits, including pre-authorization or pre-certification requirements under benefit plans for substance use disorder services. Input authorization tracking data into Insync and notify clinical leadership of pre-auth or admission needs before client appointments. Prepare and distribute financial agreements, ensuring clients understand their financial responsibility; meet with eligible clients for financial counseling and sliding scale agreements. Review daily eligibility batch reports, contacting ineligible clients to update insurance information, facilitate recertification, or manage out-of-pocket payments. Confirm appointment eligibility prior to service, notify front desk staff and clients of any ineligibility, and ensure appropriate documentation. Verify provider billing codes, review service charges for accuracy, and correct any coding issues promptly. Monitor billing submissions, ensuring services are billed within 48 hours of delivery, and address denied or unpaid claims through coordination with billing software and clinical staff. Generate and analyze billing and accounts receivable reports, assist with collections, and maintain accurate financial records. Support clinical and administrative staff with billing or insurance-related inquiries and serve as a resource for billing best practices. Manage the assessment tracker to monitor appointment no-shows, cancellations, and rescheduling activities. Requirements: Associate's degree or higher in health administration, medical billing, or related field. Minimum of 2 years' experience in healthcare billing and eligibility verification. Proven experience in medical or behavioral health billing and coding, with familiarity in insurance verification and claims processing. Strong knowledge of billing software, particularly Insync, and proficiency with Medicaid, insurance benefits, and pre-authorization procedures. Excellent organizational skills with the ability to multitask and prioritize in a fast-paced environment. Effective communication skills to liaise with clients, clinical staff, and insurance providers. Attention to detail and accuracy in reviewing charges, coding, and documentation. Ability to work on-site, with availability to coordinate with clinical and administrative teams. Familiarity with confidentiality regulations and compliance standards related to healthcare information. Nice to Have Skills: Experience working with Medicaid and other government-funded programs. Basic understanding of behavioral health services and clinical workflows. Certification in medical billing or coding (e.g., CPC, CPRS). Bilingual abilities to serve diverse patient populations. #J-18808-Ljbffr