Behavioral Health Medical Biller

Behavioral Health Medical Biller:

The Behavioral Health Medical Biller is responsible for submitting claims to insurance companies and other payers for behavioral health services. This role requires a deep understanding of mental health billing practices, insurance verification, reimbursement procedures, and compliance regulations. The ideal candidate will ensure accurate and timely billing and contribute to the organization’s financial health by minimizing denials and optimizing reimbursements. 

Hybrid work environment will be considered upon completion of the initial training period. 

Key Responsibilities

Billing and Claims Submission

• Accurately prepare and submit claims for behavioral health services to commercial payers, Medicare, Medicaid, and other third-party insurers.
• Ensure CPT, HCPCS, and ICD-10 codes are correctly applied for each patient visit and service.
• Monitor and reconcile claim submissions and address rejections and denials.

Accounts Receivable and Follow-Up

• Track outstanding claims and perform timely follow-up to ensure payments are received.
• Investigate and resolve unpaid or incorrectly paid claims.
• Communicate with payers to clarify billing issues and negotiate denials when necessary.

Insurance Verification and Pre-Authorization

• Verify patient insurance coverage and benefits before services are rendered.
• Obtain pre-authorizations and ensure compliance with payer requirements.

Patient Billing and Customer Service

• Prepare and send patient statements and respond to patient inquiries regarding their billing.
• Assist with setting up payment plans when necessary.

Documentation and Compliance

• Maintain detailed and organized documentation of all billing activities.
• Ensure compliance with HIPAA and all applicable billing regulations and standards.

Starting Salary $20-$21/Hour

Education:

• High school diploma or equivalent required; associate’s or bachelor's degree in health administration or related field preferred.
• Certification as a Certified Professional Biller (CPB) or Certified Medical Reimbursement Specialist (CMRS) is preferred.

Experience:

• Minimum 2 years of medical billing experience, preferably in a behavioral or mental health setting.
• Familiarity with billing software (e.g., Kareo, AdvancedMD, or similar EHR/PM systems).

Skills:

• Strong knowledge of behavioral health CPT codes, ICD-10, and payer policies.
• Detail-oriented with excellent organizational skills.
• Strong communication skills for interacting with payers, patients, and team members.
• Ability to work independently and manage multiple priorities.