Medical Billing Specialist

We are seeking an experienced and highly organized Medical Billing Specialist to join our growing behavioral health practice. This position focuses primarily on medical billing, insurance follow-up, accounts receivable, denial management, payment posting, and collections, with opportunities to assist with provider credentialing and payer enrollment as needed.

The ideal candidate has strong hands-on experience managing the full revenue cycle and understands the importance of timely, accurate billing and persistent insurance follow-up. Behavioral health or psychiatry billing experience is strongly preferred.

Key Responsibilities

Medical Billing & Revenue Cycle

* Prepare, review, and submit clean electronic and paper claims to commercial and government payers.
* Review daily billing activity to ensure claims are submitted accurately and timely through the clearinghouse.
* Review patient charges and supporting documentation for coding and billing accuracy.
* Monitor claim status and promptly resolve claim rejections, clearinghouse edits, and denials.
* Prepare and submit corrected claims, reconsiderations, and formal appeals.
* Post insurance payments, patient payments, contractual adjustments, and write-offs accurately.
* Reconcile payments and identify underpayments or reimbursement discrepancies.
* Verify insurance eligibility and benefits when necessary.
* Maintain complete and accurate documentation of billing activity within the practice management system.
* Ensure billing practices comply with payer requirements, HIPAA, and applicable regulations.

Insurance Follow-Up & Accounts Receivable

* Proactively follow up on outstanding claims with insurance carriers through payer portals, telephone calls, and written correspondence.
* Research and resolve unpaid, underpaid, rejected, and denied claims
* Work insurance aging reports and prioritize accounts requiring immediate follow-up.
* Identify recurring denial and payment trends and escalate systemic issues to management.
* Track appeals and corrected claims through final resolution.
* Assist with reducing aging A/R and improving overall collection performance.
* Communicate with patients regarding outstanding balances professionally and respectfully.
* Collect applicable copayments, deductibles, coinsurance, and other patient-responsibility balances.
* Send patient statements and correspondence explaining outstanding balances.
* Respond to patient billing questions and assist with resolving payment disputes.
* Recommend accounts for payment arrangements, collections, or management review when appropriate.

Credentialing & Payer Enrollment

* Assist with provider credentialing and recredentialing applications.
* Maintain accurate and current CAQH profiles.
* Assist with enrollment of providers with commercial insurance plans, Medicare, Medicaid, and other payer networks.
* Track credentialing and enrollment applications from submission through approval.
* Maintain provider documentation, including licenses, DEA registrations, malpractice coverage, and board certifications.
* Monitor credentialing expiration dates and renewal requirements.
* Communicate with payer representatives to resolve enrollment or credentialing issues.

Reporting & Administrative Responsibilities

* Perform daily, weekly, and monthly billing and revenue-cycle reconciliation activities.
* Generate and review billing, collections, denial, and A/R aging reports.
* Identify trends in denials, underpayments, and reimbursement issues and recommend process improvements.
* Maintain strict confidentiality of patient information and comply with HIPAA requirements.
* Collaborate with providers, front-office staff, and management to improve billing accuracy and reimbursement.
* Perform additional revenue-cycle responsibilities as assigned.

Qualifications

Experience

* **3–5 years of medical billing, insurance follow-up, and collections experience required.
* Behavioral health, mental health, or psychiatry billing experience strongly preferred
* Experience working with commercial insurance plans, Medicare, and Medicaid.
* Demonstrated experience resolving denied, rejected, and underpaid claims.
* Experience with electronic health records (EHR), practice management systems, and clearinghouses.
* Knowledge of corrected claims, reconsiderations, appeals, payment posting, and A/R management.
* Credentialing or payer enrollment experience is a plus.
* Strong understanding of HIPAA, payer requirements, and medical billing guidelines.

Skills

* Strong understanding of the complete medical revenue cycle
* Excellent organizational and time-management skills.
* Strong analytical and problem-solving abilities.
* Exceptional attention to detail and accuracy.
* Effective written and verbal communication skills.
* Ability to independently manage a high-volume A/R workload and meet deadlines.
* Ability to communicate professionally with insurance representatives, patients, providers, and management.
* Proficiency in Microsoft Office, particularly Excel.
* Ability to work independently and collaboratively in a fast-paced healthcare environment.

Preferred Qualifications

* Medical Billing and Coding Certificate or professional certification such as CPC, CPB, or CRCR
* Behavioral health or psychiatry billing experience.
* Experience billing **telehealth and behavioral health services
* Familiarity with DrChrono or similar EHR/practice management systems.
* Experience with provider credentialing, CAQH, and payer enrollment.

What We Are Looking For

We are looking for someone who does more than simply submit claims. The successful candidate will own the revenue cycle, consistently follow up on outstanding claims through resolution, investigate reimbursement discrepancies, identify denial trends, and help ensure services are appropriately reimbursed.

The ideal candidate is proactive, persistent, detail-oriented, accountable, and comfortable working independently while communicating effectively with the broader practice team.