The Medical Biller manages all aspects of billing for mental health and psychiatric services, ensuring accurate claim submission, timely reimbursement, and compliance with payer, regulatory, and organizational standards. Responsibilities include preparing and submitting electronic and paper claims, verifying insurance eligibility, ensuring accurate behavioral health coding (CPT, ICD-10, HCPCS), following up on unpaid/denied claims, communicating with insurers about claim status and appeals, posting payments and reconciling accounts receivable, maintaining regulatory compliance, collaborating with clinical staff to support documentation, identifying denial trends, and maintaining HIPAA confidentiality.

Required qualifications include a high school diploma or equivalent (Associate's or Bachelor's degree preferred), 2-3 years medical billing experience preferably in mental health or psychiatry, knowledge of behavioral health billing codes and payer requirements, experience with EMR and billing systems, and strong understanding of Medicare, Medicaid, and commercial insurance processes.

Preferred qualifications include Certified Professional Biller (CPB) or Certified Coding Specialist (CCS) certification, experience with behavioral health EMR systems (e.g., InSync), and familiarity with prior authorization and utilization review processes.

Core competencies involve expertise in behavioral health billing, attention to detail to ensure coding and billing accuracy, strong analytical skills for resolving claim denials and recommending process improvements, effective communication with insurance representatives, patients, and internal staff, and strict adherence to HIPAA and regulatory compliance while maintaining confidentiality and ethical billing practices.