medicaid billing specialist

FAMILY TIES, INC.

<p><b>MUST HAVE MEDICAID &amp; MENTAL HEALTH BILLING EXPERIENCE</b></p><p><b>About the Role</b></p><p>We are seeking an experienced and highly organized <b>Behavioral Health Billing Manager </b>to join our growing team. This role is critical to ensuring accurate, compliant, and timely billing for behavioral health services. The ideal candidate is detail-oriented, proactive, and well-versed in Medicaid and Private insurance mental health billing, DBHDD policies and procedures, and provider credentialing.</p><p>If you thrive in a fast-paced healthcare environment, enjoy problem-solving, and understand the importance of compliance in behavioral health services, this role is an excellent fit. This role goes beyond billing&mdash;it directly supports access to quality behavioral health care. You&rsquo;ll be part of a supportive, mission-driven team where your expertise ensures compliance, financial stability, and a smooth experience for both clients and providers. Your work truly makes a difference.</p><p><b>Key Responsibilities</b></p><p><b>Billing &amp; Revenue Cycle Management</b></p><ul><li>Manage and maintain accurate, up-to-date client billing records</li><li>Review referrals, authorizations, and clinical documentation for billing compliance</li><li>Submit and track Medicaid and commercial insurance claims for mental health services</li><li>Ensure compliance with DBHDD, Medicaid, and payer-specific billing rules</li><li>Transfer and verify billing and insurance data with precision</li><li>Monitor accounts receivable and follow up on unpaid or denied claims</li><li>Investigate and resolve billing discrepancies and payment issues</li><li>Set up and manage payment plans when necessary</li><li>Send professional, timely payment reminders (friendly but firm)</li></ul><p><b>Insurance &amp; Compliance</b></p><ul><li>Verify insurance eligibility, benefits, and authorizations</li><li>Navigate Medicaid, HMOs, PPOs, and state-funded behavioral health programs</li><li>Stay current on DBHDD policies, Medicaid updates, and payer requirements</li><li>Serve as a point of contact for billing-related questions from clients and insurance companies</li></ul><p><b>Credentialing &amp; Provider Support</b></p><ul><li>Manageemployee and provider credentialing for Medicaid and other payers</li><li>Track credentialing and recredentialing timelines to ensure uninterrupted billing</li><li>Maintain organized credentialing files and documentation</li></ul><p><b>Required Qualifications</b></p><ul><li><b>Minimum 2+ years of Medicaid billing experience (REQUIRED)</b></li><li><b>Mental health / behavioral health billing experience (REQUIRED)</b></li><li><b>Strong knowledge of DBHDD policies and procedures (REQUIRED)</b></li><li><b>Experience with employee/provider credentialing (REQUIRED)</b></li><li>Bachelor&rsquo;s degree in Accounting, Healthcare Administration, Finance, Business, or related field (preferred)</li><li>Proficiency in Microsoft Office (Excel required); QuickBooks experience strongly preferred</li><li>Excellent multitasking, time management, and organizational skills</li><li>Ability to work independently and take initiative</li><li>Strong communication and customer service skills</li><li>Ability to clearly explain billing and insurance information to clients and payers</li><li>High attention to detail and strong problem-solving skills</li></ul><p><b>Benefits</b></p><ul><li>401(k)</li><li>Health Insurance</li><li>Dental Insurance</li><li>Vision Insurance</li><li>Paid Time Off</li><li>Referral Program</li></ul><p><b>Why Join Us?</b><br/>This is more than just numbers and spreadsheets&mdash;it&rsquo;s about helping people get the care they need, ensuring their billing experience is smooth, and making sure nothing falls through the cracks. You'll be part of a supportive team where your work truly matters.</p><p>Job Type: Full-time</p><p>Pay: $45,000.00 - $50,000.00 per year</p><p>Benefits:</p><ul><li>401(k)</li><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Referral program</li><li>Vision insurance</li></ul><p>Experience:</p><ul><li>Behavioral Health Billing : 2 years (Required)</li></ul><p>Ability to Commute:</p><ul><li>Atlanta, GA 30328 (Required)</li></ul><p>Work Location: Hybrid remote in Atlanta, GA 30328</p>

Behavioral Health Billing Manager

Oregon Youth Authority

<p><b>OREGON YOUTH AUTHORITY</b></p><p>Accountant 1 - Medical Billing Specialist</p><p>Salem, OR &ndash; Equitable Center</p><p>The Oregon Youth Authority is seeking an <b>Accountant 1 &ndash; Medical Billing Specialist</b> to provide essential financial and accounting support that ensures the accuracy, integrity, and timeliness of agency transactions and reporting. In this role, you will collaborate with staff across the organization to perform complex accounting functions, apply established methods and controls, and support informed decision-making through reliable financial data.</p><p>A primary focus of this position is managing Medicaid billing processes, including targeted case management (TCM), Behavioral Rehabilitation Services (BRS), and reimbursements through the Medicaid Management Information System (MMIS). Responsibilities include reviewing and verifying medical billing codes and reimbursement rates for provider payments; tracking and maintaining documentation supporting reimbursement claims to ensure accuracy, completeness, and audit compliance; and reviewing and analyzing remittance advice from the Oregon Health Authority (OHA) to verify paid and denied claims, identify discrepancies, and ensure compliance with Medicaid requirements.</p><p>As a subject matter expert in medical payment claims, you will provide guidance on billing practices, resolve discrepancies, and ensure sensitive financial and medical information is handled in accordance with OYA policy, HIPAA, and other applicable standards. This role plays a critical part in supporting expenditure recovery, fiscal accountability, and compliance while contributing to a collaborative, inclusive, and mission-driven work environment.</p><p><b>Top Duties of the Position:</b></p><ul><li>Review and verify medical billing codes and reimbursement rates for payments to providers</li><li>Track and maintain records supporting reimbursement claims, ensuring accuracy, completeness, and compliance with audit requirements.</li><li>Review and analyze remittance advice from the Oregon Health Authority (OHA) to verify accuracy of paid and denied claims, identify discrepancies, and ensure compliance with Medicaid billing and reimbursement requirements.</li></ul><p><b>Minimum Qualifications:</b></p><p>Possession of a Certified Public Accountant or Certified Government Financial Manager certificate; <b>OR</b></p><p>A bachelor&rsquo;s degree in accounting; <b>OR</b></p><p>Successful completion of the State of Oregon Accounting Career Mobility Program or equivalent accounting certificate program from an accredited college or university; <b>OR</b></p><p>32 quarter (21 semester) credit hours in Accounting from an accredited institution two years of technical, para- professional accounting experience to include: a) classifying, analyzing, and reconciling financial data and records; b) designing, recommending, and installing modifications of accounting methods, procedures, forms, and records; c) preparing financial statements and reports; d) analyzing and interpreting laws, regulations, codes, and ordinances to ensure the legality of financial transactions; and e) analyzing, interpreting, and making recommendations related to accounting transactions, accounts and account relationships resulting in accounting entries.</p><p><b>Required Skills:</b></p><ul><li>Ability to work with diverse groups of internal clients.</li><li>Excellent attention to detail and number typing accuracy.</li><li>Proficiency in Excel and other relevant software (e.g., ORMB, Epic Tapestry Membership, SharePoint).</li><li>Knowledge of ICD-9/ICD-10, HCPCS, CPT coding conventions.</li><li>Ability to work to tight deadlines in a fast-paced environment.</li><li>Ability to maintain professionalism, confidentiality, and objectivity under pressure.</li><li>Knowledge of medical terminology and regulations on the confidentiality of medical records (HIPAA).</li><li>Possess an understanding of basic principles of governmental accounting and financial reporting.</li><li>Ability to apply accounting theory to solve or evaluate solutions to problems and to document and communicate the application of theory.</li><li>Must remain current with the capabilities of various software applications as well as other aspects of the profession by attending training/education sessions.</li></ul><p><b>Desired Attributes:</b></p><ul><li>Experience with HIPAA requirements for information handling</li><li>Experience with medical billing, including reviewing HCFA forms and ICD-10 coding</li><li>Demonstrated experience with Medicaid billing requirements, specifically related to Title XIX program</li><li>Demonstrated experience with financial reconciliations</li><li>Demonstrated problem-solving skills, critical thinking skills, and oral and written communication skills</li><li>Positive, professional, and reliable</li></ul><p><b>How to Apply: </b></p><ul><li><b>COVER LETTER AND RESUME REQUIRED:</b> In your cover letter, please describe your experiences, skills, and knowledge as they relate to the desired attributes of the position and explain why you are the best fit for this role. Limit your cover letter to no more than 2 pages and ensure it is in PDF format for accessibility.</li><li>Ensure your application and/or resume thoroughly reflect your skills, experience (both lived and professional), knowledge, and/or education pertinent to this position, including how you meet the minimum qualifications and any/all desired attributes. Include in your resume <b>dates of employment</b> and descriptions of duties/responsibilities for each position.</li><li><b>After you submit your application, please respond to the public records request authorization and gender identity questionnaire. </b>This step will come after you submit and will complete the process. <b>If you are an employee, the tasks will come to your Workday inbox.</b></li><li><b>If you are a veteran, you may receive preference. </b>Click here for more information about veterans&rsquo; preference. The task to claim preference will come after the public records request and gender identity questionnaire tasks. Click here for a guide on how to upload your documents. <b>For privacy reasons</b>, please <b>do not attach</b> your DD214/DD215/civil service preference letter to your application or combine it with any other required document attachments.</li></ul><p><b>Caution: If you fail to follow these instructions, including failing to attach a resume and cover letter as described above, we will have to disqualify your application. We cannot consider incomplete or late applications. </b></p><p><b>Additional Details:</b></p><ul><li><b>Hybrid Telework: </b>This position is eligible for a hybrid remote work schedule; you will be required to come into the office 3-4 days per month. Employees may be required to be in the office more frequently in response to business needs. Remote work is evaluated periodically to ensure business needs are being met and can be adjusted at any time.</li><li>This recruitment will be used to establish a list of qualified candidates to fill current and future vacancies.</li><li><b>Your application materials are used to determine your starting salary range. </b>Through an equal pay assessment, we will determine the salary offer using the information you provide in your submitted application materials. Please ensure your application materials are detailed, accurate and reflect your skills, experience (paid and unpaid) and education as they relate to the position when applying. For more information on pay equity, click here.</li><li>The salary range listed is the non-PERS participating rate. If you are already a participating PERS member or once you become PERS eligible, the salary range will increase by 6%. Please review the Classification and Compensation page for more details.</li><li>This position receives annual increases on the anniversary date until the maximum of the salary range is reached.</li><li>Please save a copy of this job announcement for your reference, as it may not be available for you to view after the job closes.</li></ul><p><b>Tentative Recruitment Schedule:</b></p><ul><li><b>1st Round Interviews (virtual - Teams): April 29, 2026</b></li><li><b>2nd Round Interviews (in-person): May 6, 2026</b></li></ul><p><b>Would you like to learn more about this position or how our application process works? Join our Recruitment team during our OYA Career Chat Sessions every other Wednesday between 11am-11:30am PST. We can assist you with all your application and agency questions!</b></p><p><b>Click Here to Register for OYA Career Chats!</b></p><p><b>ABOUT OYA</b></p><p>At OYA, diversity, equity, and inclusion are more than just words on a page. To meet our mission and live our values as an agency, DEI must be at the heart of all we do. We support cultural competence, develop teams and cultivate leaders in ways that are equitable to everyone, especially people of color, those who identify as LGBTQ+, or those from other marginalized communities. We are explicit and intentional as we identify resources that all our youth and staff need to grow and prosper. Our DEI work connects closely with our culture of positive human development, with safe and supportive environments where everyone is held accountable and connected to their community. The end goal is to protect the public and reduce crime by holding youth accountable and providing opportunities for reformation in safe environments.</p><p>If you are looking to join a team that values individual and cultural differences, with the opportunity to contribute to youth reformation by enriching our workforce with diversity, <i><b>OYA wants to hear from you</b></i>! People of color, women, and other members of historically marginalized communities are strongly encouraged to apply!</p><p><b>For more information please visit www.oregon.gov/oya.</b></p><p><b>What's in it for You?</b><br/>OYA values our employees. We believe that your time outside of the workplace is as valuable as it is inside the workplace. We offer a <b>great work/life balance</b> with <b>flexible </b>work schedules on most positions and a <b>competitive</b> benefits package, including low-cost, high-coverage health insurance, generous time-off, and a competitive retirement plan.</p><p><b>Discover more about working in Oregon state government by clicking here.</b></p><p><b>This position is represented by the Service Employees International Union (SEIU/OPEU). By joining and maintaining your membership with SEIU Local 503, the following benefits are available to you such as:</b></p><ul><li><b>$2,500 life insurance policy</b> paid for by your union, SEIU Local 503. This policy is in effect if you are an active member.</li><li><b>Up to $200,000 of additional life insurance</b> can be purchased. Up to $100,000 member life, $40,000 spouse and $10,000 child is guaranteed within the first 90 days of new union membership.</li><li><b>Short Term Disability insurance</b> is guaranteed if purchased within the first 90 days of new union membership.</li><li><b>Legal insurance</b> enrollment is available to purchase within the first 90 days of new union membership.</li><li><b>Tuition reimbursement.</b></li></ul><p><b>For more information on SEIU, please click here.</b></p><p><b>Additional Information:</b></p><p><b>Our goal is to be a diverse workforce that is representative, at all job levels, of the citizens we are here to serve. OYA is an equal opportunity and affirmative action employer. All aspects of employment including the decision to hire, promote, discipline, or discharge, will be individualized based on merit, competence, performance, and business need.</b></p><p><b>We do not discriminate on the basis of race, color, religion, marital status, age, national origin, ancestry, physical or mental disability, medical​​​ condition, pregnancy, genetic information, gender, sexual orientation, gender identity or ​expression, veteran status, or any other status protected under federal, state, or local law.&rdquo; The more diverse we are, the better our work will be.</b></p><p><b>Applicants with a disability may request a reasonable accommodation to participate in the hiring process. For assistance regarding reasonable accommodation or for alternative format please contact OYA Recruitment at 971-345-1236. Oregon Relay Service can be reached by calling 7-1-1.</b></p><p><b>Pre-employment Checks: </b></p><p>In keeping with our mission, OYA will conduct a criminal record check, per OAR 416 Division 800, a driving record background check and a vulnerable population abuse and neglect check. Information obtained about an individual is confidential. An individual who refuses to consent to a criminal records/background check shall be disqualified from consideration in the position for which you applied. All applicants are subject to additional pre-employment check(s) such as fingerprint based on criminal records check, pre-employment drug screening and/or education verification as required for the position.</p><p>In 2003 Congress passed the Prison Rape Elimination Act (PREA), the first federal civil statue focused specifically on addressing sexual violence in juvenile facilities, jails, prisons, and other facilities. In recognition of the rights, safety, and well-being of the youth we serve you will be asked specific questions about your background to ensure our hiring and promotion practices comply with the National PREA standards.</p><p><b>All positions in OYA will require the incumbent to serve as a &quot;mandatory reporter&quot; of child abuse.</b></p><p><b>Visa Sponsorship:</b></p><p>We do not offer Visa sponsorship. If you are hired, you will be required to fill out the US Department of Homeland Security&rsquo;s I-9 form confirming you are able to work in the US. OYA uses E-Verify to confirm that applicants are authorized to work in the United States.</p><p><b>Have Questions?: </b></p><p>For questions about the job announcement, email the OYA recruitment team at OYAjobs@oya.oregon.gov.</p><p>Pay: $4,519.00 - $6,904.00 per month</p><p>Benefits:</p><ul><li>Employee assistance program</li><li>Flexible spending account</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Parental leave</li><li>Retirement plan</li><li>Vision insurance</li></ul><p>Work Location: Hybrid remote in Salem, OR 97301</p>

Accountant 1 - Medical Billing Specialist

Tata Consultancy Services (TCS)

<div></div><div><div><div><div><div>Must Have Technical/Functional Skill</div><br>
<div><br>
</div><ul><li> 10+ years of experience in IT project management
</li></ul><ul><li> Medicare/Medicaid domain knowledge and understanding of Enrollment and Billing processes for Medicaid, Dental and vision benefits
</li></ul><ul><li> Experience with Products implementation and coordination of the work across Business, IT and vendor teams
</li></ul><ul><li> Experience managing requirements in JiraAlign and ADO tools
</li></ul><ul><li> Proven track record in managing large-scale, complex projects.
</li></ul><ul><li> Excellent communication, leadership, and organizational skills.
</li></ul><ul><li> Agile Certification (SAFe, CSM, or equivalent)
</li></ul><ul><li> Project Management certification (PMP, Prince2, or equivalent)</li></ul><br>
<div><br>
</div><div>Roles &amp; Responsibilities
</div><ul><li> Lead end-to-end project management for product modernization initiatives across the Billing and Enrollment platforms.
</li></ul><ul><li> Partner with business stakeholders, vendors, and Humana IT teams to define project scope, objectives, and key deliverables.
</li></ul><ul><li> Collaborate with Product Management to ensure scope is clearly defined and captured in requirement management tools for PI prioritization.
</li></ul><ul><li> Develop and manage detailed project plans, schedules, and budgets; proactively track progress and adjust as needed.
</li></ul><ul><li> Identify, assess, and manage project risks, issues, and dependencies to ensure smooth execution.
</li></ul><ul><li> Coordinate resources, facilitate governance and working sessions, and drive effective communication across all project participants.
</li></ul><ul><li> Ensure deliverables meet quality standards and comply with security, privacy, and regulatory requirements.
</li></ul><ul><li> Provide clear, timely status updates and progress reports to leadership and key stakeholders.
</li></ul><ul><li> Build and maintain strong partnerships with vendors and internal teams to ensure successful solution delivery.</li></ul><div><br>
</div>
<div></div><br>
<div>Salary Range $100,000-$135,000Per year
</div>
<div></div><div>TCS Employee Benefits Summary:
</div><div>Discretionary Annual Incentive.
</div><div>Comprehensive Medical Coverage: Medical &amp; Health, Dental &amp; Vision, Disability Planning &amp; Insurance, Pet Insurance Plans.
</div><div>Family Support: Maternal &amp; Parental Leaves.
</div><div>Insurance Options: Auto &amp; Home Insurance, Identity Theft Protection.
</div><div>Convenience &amp; Professional Growth: Commuter Benefits &amp; Certification &amp; amp; Training Reimbursement.
</div><div>Time Off: Vacation, Time Off, Sick Leave &amp; Holidays.
</div><div>Legal &amp; Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing.
</div>
<div></div><div>#LI-SP1
</div></div></div></div><div><div><div><b>Location</b></div>
<div>Louisville, KY</div>
</div><div><div><b>Job Function</b></div>
<div>TECHNOLOGY</div>
</div><div><div><b>Role</b></div>
<div>Project Manager</div>
</div><div><div><b>Job Id</b></div>
<div>407253</div>
</div><div><div><b>Desired Skills</b></div>
<div>Agile
</div></div><div><div><b>Salary Range</b></div>
<div>$100,000-$135,000 a year</div>
</div></div><p>Desired Candidate Profile
</p><div><div><b>Qualifications</b> : BACHELOR OF COMPUTER SCIENCE</div></div></div><div></div>

Project Manager with Medicaid Enrollment and Billing Experience

Hope Esperanza Services, LLC

<p><i><b>Hope Esperanza Services, LLC,</b></i> <i>is a multi-service Mental Health Agency in Dunellen, NJ, seeking to expand the business throughout NJ.</i></p><p><b>Position Summary</b></p><p>The Accountant / Payroll &amp; Billing Specialist will be responsible for managing bi-monthly payroll, overseeing billing processes (including Medicaid and DCPP claims), maintaining accurate financial records, and ensuring compliance with payroll and billing regulations.</p><p><b>Key ResponsibilitiesPayroll Duties</b></p><ul><li>Process bi-monthly payroll accurately and on time via QuickBooks</li></ul><ul><li>Maintain employee and contractor payroll records, including hours worked</li></ul><ul><li>Ensure timesheets are completed accurately and submitted on time</li></ul><ul><li>Submit 1099s and W-2s (federal and state) via QuickBooks</li></ul><ul><li>Resolve payroll discrepancies and respond to employee/contractor payroll inquiries</li></ul><ul><li>Ensure compliance with payroll laws and regulations</li></ul><p><b>Billing Duties</b></p><ul><li>Prepare and issue accurate invoices to DCPP via K100</li></ul><ul><li>Prepare and submit Medicaid claims via CMS-1500</li></ul><ul><li>Verify billing data, rates, and supporting documentation</li></ul><ul><li>Monitor accounts receivable and follow up on outstanding payments</li></ul><ul><li>Maintain organized billing and financial records</li></ul><ul><li>Ensure compliance with Medicaid and state billing requirements</li></ul><p><b>Qualifications</b></p><ul><li>Bachelor&rsquo;s degree in Accounting, Finance, Business Administration, or related field (preferred)</li></ul><ul><li>Proven experience in payroll processing and billing</li></ul><ul><li>Knowledge of payroll systems and accounting software (QuickBooks experience preferred)</li></ul><ul><li>Strong understanding of payroll regulations and compliance requirements</li></ul><ul><li>High attention to detail and accuracy</li></ul><ul><li>Strong organizational and time-management skills</li></ul><ul><li>Ability to handle confidential information with integrity</li></ul><p><b>Preferred Experience</b></p><ul><li>Experience working in healthcare, social services, or nonprofit organizations</li></ul><ul><li>Familiarity with Medicaid billing, DCPP invoicing, and government billing systems</li></ul><p>Job Type: Part-time</p><p>Pay: $15.00 - $20.00 per hour</p><p>Ability to Commute:</p><ul><li>Dunellen, NJ 08812 (Required)</li></ul><p>Work Location: In person</p>

Accountant/ Payroll & Billing Specialist

Piedmont Retina Specialists

<p><b>Job Title:</b> Billing and Collections Specialist<br/><b>Location:</b> Greensboro, NC<br/><b>Practice Type:</b> High-Volume Ophthalmology Practice<br/><b>Employment Type:</b> Full-Time</p><p><b>Overview:</b><br/>Our well-established retina ophthalmology practice in Greensboro, NC is seeking a detail-oriented and experienced <b>Billing and Collections Specialist</b> to join our dynamic team. This role requires a strong background in medical billing specific to ophthalmology, with a focus on Medicare, Medicaid, and commercial insurance plans. The ideal candidate is not only technically proficient but also empathetic and professional when working with patients&mdash;especially our elderly population.</p><p><b>Key Responsibilities:</b></p><ul><li>Accurately process and manage billing for a high-volume ophthalmology practice</li><li>Ensure proper coding with ICD-10 and CPT, with a focus on ophthalmologic procedures</li><li>Handle insurance verification, prior authorizations, and eligibility checks</li><li>Manage patient collections with a courteous and compassionate approach</li><li>Address patient billing inquiries clearly and effectively</li><li>Work collaboratively with clinical and administrative teams to resolve billing discrepancies</li></ul><p><b>Qualifications:</b></p><ul><li>Minimum 2 years of experience in medical billing and collections, preferably in ophthalmology/retina</li><li>Proficient in ICD-10, Medicare/Medicaid billing guidelines, and EMR systems</li><li>Strong understanding of insurance policies including Medicare Advantage and NC Medicaid</li><li>Excellent organizational, communication, and problem-solving skills</li><li>Ability to maintain a professional and kind demeanor, especially with elderly patients</li><li>Dependable and punctual, with a strong work ethic and attention to detail</li></ul><p><b>Preferred Traits:</b></p><ul><li><b>Team Player:</b> Willing to collaborate and assist where needed</li><li><b>Excellent Communicator:</b> Able to understand and convey information clearly</li><li><b>Highly Reliable:</b> Consistently punctual and committed to quality patient care</li><li><b>Positive Attitude:</b> Displays grace, patience, and kindness in all interactions</li><li><b>Self-Starter:</b> Proactively takes initiative and uses time efficiently</li></ul><p><b>Compensation &amp; Benefits:</b></p><ul><li>Competitive salary based on experience</li><li>Health insurance (company-sponsored) after 90 days</li><li>Paid holidays</li><li>3 weeks of paid vacation per year</li><li>401(k) with company match after one year</li><li>Bonus structure available after one year of employment</li></ul><p>Job Type: Full-time</p><p>Pay: $22.00 - $25.00 per hour</p><p>Benefits:</p><ul><li>401(k)</li><li>401(k) matching</li><li>Health insurance</li><li>Paid time off</li></ul><p>Work Location: In person</p>

Billing and Collections Representative

SunArch Academy

<div><div><p>SunArch Academy, an inpatient Psychiatric Residential Treatment Facility (PRTF), is seeking an experienced Billing Specialist with a strong background in inpatient psych billing. This role is critical to supporting our mission by ensuring accurate, compliant billing processes for our adolescent behavioral health program.</p>
</div>
<div><p>What You&rsquo;ll Do</p>
</div>
<div><ul><li><p>Manage full-cycle billing for inpatient psychiatric services, including daily census, authorizations, and continued-stay requirements</p>
</li>
</ul></div><div><ul><li><p>Verify benefits and pre-certifications specific to inpatient behavioral health</p>
</li>
</ul></div><div><ul><li><p>Prepare, submit, and track inpatient claims through Medicaid and commercial insurance</p>
</li>
</ul></div><div><ul><li><p>Monitor claim status, resolve denials, and ensure timely reimbursement</p>
</li>
</ul></div><div><ul><li><p>Review clinical documentation for accuracy, compliance, and proper coding</p>
</li>
</ul></div><div><ul><li><p>Reconcile payments, maintain patient account accuracy, and identify discrepancies</p>
</li>
</ul></div><div><ul><li><p>Partner with clinical, admissions, and administrative teams to ensure smooth billing operations</p>
</li>
</ul></div><div><p>What We&rsquo;re Looking For</p>
</div>
<div><ul><li><p>Inpatient psychiatric/behavioral health billing experience is required</p>
</li>
</ul></div><div><ul><li><p>Strong knowledge of Medicaid billing, authorization processes, and inpatient psych regulations</p>
</li>
</ul></div><div><ul><li><p>Understanding of codes, modifiers, and documentation requirements for PRTF/inpatient services</p>
</li>
</ul></div><div><ul><li><p>High attention to detail and strong problem-solving skills</p>
</li>
</ul></div><div><ul><li><p>Ability to work independently while supporting a fast-paced, mission-driven environment</p>
</li>
</ul></div><div><ul><li><p>EMR/EHR experience preferred</p>
</li>
</ul></div><div><p>Why SunArch Academy</p>
</div>
<div><ul><li><p>Join a compassionate, dedicated team serving youth in a highly structured therapeutic environment</p>
</li>
</ul></div><div><ul><li><p>Opportunity to build processes and make a meaningful impact in a growing inpatient program</p>
</li>
</ul></div><div><ul><li><p>Supportive leadership and career development opportunities</p></li></ul></div></div><p></p>

Billing Specialist – Inpatient Behavioral Health

Family Health Centers of Southwest Florida

<div>Description:
<p><b>
POSITION DESCRIPTION:</b></p><p>
The Billing Specialist is responsible for timely, accurate and comprehensive billing of all provider services utilizing appropriate CPT, HCPCS and ICD-10 diagnosis codes. The individual prepares and submits clean claims to Medicare, Medicaid, Commercial insurance carriers, and Self-Pay patients and works rejections.</p><p><b>
DUTIES AND RESPONSIBILITIES:</b></p><ul><li>
Submits claims to payers based on review of medical records and in accordance with Medicare, Medicaid, and Commercial insurance guidelines as well as FHCSWF policies and procedures.</li><li>
Reviews information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information to ensure clean claim submission.</li><li>
Enters charges accurately and expeditiously to ensure proper records handling and fast payment.</li><li>
Timely filing of insurance claims to clearinghouse or individual insurance companies electronically or via paper.</li><li>
Review and correction of claim edits within 24 hours of being received from clearinghouse and internal claims scrubber.</li><li>
Initiates private pay collections after insurance cancellation, denial or other issue and answer patient questions on patient responsible portions, copays, deductibles, write-offs, etc.</li><li>
Performs self-pay patient billing.</li><li>
Prepares and sends patient statements for charges not covered by insurance.</li><li>
Other duties as assigned.</li></ul>
Requirements:
<p><b>
KNOWLEDGE:</b></p><ul><li>
Demonstrated knowledge of Medicaid, Medicare, and Commercial Insurance rules and procedures in a managed care plan environment</li><li>
Medical terminology, CPT, HCPCS and ICD-10 coding and modifier usage</li><li>
Understanding of FQHC billing procedures and Sliding Fee Schedules a plus</li><li>
EHR systems expertise, preferably with Intergy or other ambulatory care facility-based system</li><li>
Understand and adhere to all HIPAA guidelines</li><li>
MS Office Suite (Excel proficiency)</li><li>
Alpha-Numeric data entry</li></ul><p><b>
SKILLS AND ABILITIES:</b></p><ul><li>
High School or Equivalent (Associates Degree preferred)</li><li>
2 Years Medical Billing experience</li><li>
CMRS, CPB, or CPC credentials a plus</li><li>
Attention to detail with strong documentation, analytic and problem-solving skills</li><li>
Ability to multi-task in a fast-paced environment</li><li>
Strong interpersonal written &amp; verbal communication skill</li></ul></div>

Billing Specialist

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