Position Overview
We are seeking a detail-oriented and experienced Billing Specialist to join our inclusive and affirming mental health practice. This position is essential to maintaining a smooth revenue cycle through accurate claims processing, efficient billing operations, and proactive communication with payers and clients. The ideal candidate will have a strong understanding of mental health billing procedures, including Ohio Medicaid, and will be comfortable working independently in a remote setting.
Key Responsibilities
Claims Processing & Revenue Cycle Management
- Correct and submit unbilled claims due to missing diagnostic codes, signatures, or pending statuses.
- Monitor claim status and follow up on rejections or denials; resubmit and appeal as needed.
- Contact payers regarding overpayments, underpayments, and recoupments within 30 days of identification.
- Process insurance write-offs for issues such as duplicates or payer errors.
- Update and maintain billing rules with the Revenue Cycle Management (RCM) vendor to improve billing efficiency.
Client Billing & Accounts Management
- Ensure client demographic and insurance information is accurate and current in the EHR system.
- Perform monthly insurance verifications for active clients.
- Address client billing inquiries professionally and provide timely resolution.
- Manage accounts receivable and support collections activity as needed.
- Maintain accurate billing logs, internal billing notes, and documentation in compliance with agency policies.
Collaboration & Compliance
- Collaborate with clinical staff to ensure documentation and coding support timely and accurate billing.
- Ensure compliance with Ohio Administrative Code (OAC), Ohio Revised Code (ORC), Medicaid requirements, and HIPAA standards.
- Stay informed of Ohio Medicaid policy updates and implement necessary billing adjustments.
- Support financial audits, compliance checks, and credentialing-related billing reviews.
Reporting & System Management
- Utilize ClinicTracker (EHR) to process claims and track financial data.
- Generate, review, and submit regular reports to monitor revenue performance and billing trends.
Credentialing & Provider Enrollment
- Assist with credentialing individual providers with Ohio Medicaid and private insurance carriers.
- Track and maintain credentialing application statuses, revalidations, and renewals.
- Collaborate with providers and administrative staff to ensure timely submission of credentialing paperwork.
- Maintain accurate records of credentialing documentation in compliance with payer and regulatory requirements.
- Communicate with carriers to resolve credentialing or enrollment-related issues affecting billing or reimbursement.
Qualifications
- Minimum 2 years of experience in medical billing, preferably in behavioral health or mental health services.
- Strong understanding of Ohio Medicaid billing guidelines and third-party insurance claim processes.
- Proficiency in EHR systems such as ClinicTracker, CareLogic, or inSync
- Working knowledge of CPT/ICD-10 coding, insurance authorization, and HIPAA compliance.
- Excellent communication and interpersonal skills.
- High level of accuracy, attention to detail, and ability to meet deadlines.
- Comfortable using inclusive, affirming, and culturally responsive language.
- Must meet all privacy and security requirements for remote work.
Requires 2+ years of medical billing experience, Ohio Medicaid and insurance claims knowledge, EHR proficiency, CPT/ICD-10 coding, authorization and HIPAA knowledge, accuracy, communication, and remote-work privacy compliance.
Key Responsibilities
- processing claims
- managing accounts
- generating reports
Skills & Tools
ClinicTracker, CareLogic, inSync, EHR, Revenue Cycle Management (RCM), CPT, ICD-10, HIPAA
Job Details
- Category: Finance and Accounting
- Seniority: Entry Level
- Commitment: Full Time
- Workplace: Remote — Toledo, Ohio, United States
- Languages: English
About Personal Growth Counseling Services
An inclusive and affirming mental health practice. — Industry: Healthcare