Billing Specialist - Patient Accounts

Kind Behavioral Health Billing SpecialistKind Behavioral Health is a leading provider of Applied Behavior Analysis services in North Carolina and Georgia, dedicated to improving the lives of children with autism spectrum disorder ("ASD"). We provide life-changing treatment to children with ASD, providing outstanding quality care, and delivering exceptional clinical outcomes, in an environment in which all are encouraged to THINK BIG, HAVE FUN, DO GOOD, and BE KIND. We deliver treatment through individualized care plans, and target socially significant behaviors, enabling the clients we serve to lead more independent, fulfilling lives.Position OverviewWe are seeking a compassionate and detail-oriented Billing Specialist to join our team, focusing on patient responsibility collections while maintaining KBH's commitment to supporting families throughout their ABA journey. This role combines insurance patient responsibility collections expertise with strong family advocacy, helping connect families with resources to cover treatment costs while ensuring strong billing processes. The ideal candidate is empathetic, organized, and skilled at building positive relationships with families during sensitive financial conversations. The Billing Specialist will serve as a bridge between our billing operations and the families we serve, always prioritizing the continued care and support of our clients, while ensuring complete and timely collections performance.Required Experience & Essential Skills1-3 years of experience in healthcare billing/collections, health insurance interactions, or patient financial servicesExperience with insurance verification, claims processing, and accounts receivableKnowledge of healthcare billing regulations and HIPAA compliance requirementsStrong customer service background with experience in sensitive financial conversationsExcellent communication skills, both written and verbalAbility to resolve complex roadblocks independently and maintain diligent follow-up processesWillingness to go above and beyond to connect families with resources and help them navigate payment for servicesFamiliarity with ABA Services preferred (CPT Codes View phone number on click.appcast.io) and Medicaid eligibilityFamiliarity with EHR systems (CentralReach preferred), and Microsoft Office Suite (Excel, Word, Outlook)Detail-oriented with strong organizational and time management skillsAbility to work independently and manage multiple priorities in a fast-paced environmentFamiliarity working with both commercial insurance and government-funded (i.e., Medicaid and TRICARE) healthcare payorsDemonstrated experience driving payor accountability – comfortable pushing on payors and advocating for insurance coverage and timely claims payment on behalf of clientsExperience working with families or in pediatric, third-party reimbursed healthcare settings preferredPatient Responsibility CollectionsManage patient responsibility accounts with kindness and professionalismDevelop and maintain flexible payment plans tailored to each family's unique financial circumstances, while ensuring ongoing adherence to agreed upon plansMaintain detailed records of all collection activities, payment arrangements, and family communicationsMonitor A/R aging reports to prioritize collection effortsProcess patient payments and apply them accurately to appropriate accounts and servicesFamily Resources & SupportResearch and identify financial assistance programs, grants, and community resources offering financial support for families receiving autism servicesProactively connect families with autism-specific funding organizations and state assistance programs, and nonprofit resourcesMaintain a comprehensive database of local and national resources for easy family referralsCreate educational tools and step-by-step guides for families to independently and easily access available financial assistance programsAdvocate for families during financial hardship by exploring all available support optionsBenefits & Eligibility ChecksPrimary point of contact, managing relationship with third-party automated insurance verification partner.Manage our automated insurance verification process using our third-party benefits verification platform for all new intake clients and ongoing verification for existing clientsReview monthly eligibility checks to ensure continuous coverage and proactively identify policy changesDetermine and communicate to families applicable ABA coverage limits and exclusions, deductibles, copayments, and authorization requirementsProvide clear, understandable explanations to families about their insurance benefits, coverage details, and anticipated out-of-pocket costs based on verification resultsMaintain accurate and up-to-date insurance information in patient records and promptly update any changes identifiedWhen insurance changes occur, coordinate seamlessly across authorizations, scheduling, credentialing, and billing teams to ensure uninterrupted continuation of careIdentify potential coverage gaps through platform reporting and work with families to secure alternative funding sources before service interruptionTroubleshoot any platform issues and escalate complex verification cases to vendor support when neededClaims Reprocessing & AppealsReprocess insurance claims when patient financial obligations have been incorrectly calculated or applied by insurance carriersPrepare and file formal appeals for incorrectly denied claims, including compilation and submission of supporting clinical documentationTrack appeal outcomes and follow up on pending decisions within established timeframesMaintain detailed logs of all reprocessing activities and communicate outcomes to relevant stakeholdersPayor Claims Enrollment (EFT & ERA enrollments)Complete Electronic Funds Transfer (EFT) enrollment applications for new insurance payorsSet up Electronic Remittance Advice (ERA) enrollments to streamline payment processing and reconciliationMaintain current enrollment status for all active insurance contracts and renew as neededProactively troubleshoot EFT and ERA processing issues and coordinate resolution with payor representativesUpdate banking and contact information for electronic payment systems as organizational changes occurKBH is committed to creating a diverse environment and we are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. Diversity is more than a commitment at KBH- it is the foundation of what we do, adhering to the highest professional standards while creating an environment in which exceptional people (like you!) can think big, have fun, and do good.