Purpose-driven role supporting a mission-oriented behavioral health organization serving Western Massachusetts.
Responsible for follow-up on assigned claims at 45, 60, and 90 days to support timely reimbursement and claim closure. Reviews denied claims for accuracy, confirms coding, billing rates, and modifiers, and prepares appeals or reconsiderations to payers. Investigates claims with no payer response, uses payer websites and appeal processes, and identifies denial trends to reduce future errors. Works with the EHR Matrix team and Billing Manager on coding or modifier setup issues. Also identifies missing payments, overpayments, and credit balances, and initiates refund requests when needed.
This is a remote position with an 8:00 AM to 4:00 PM Eastern schedule.
High school diploma or GED required.
Minimum 5 years of experience in a medical billing department with strong accounts receivable follow-up, appeals, and behavioral health code and modifier knowledge.
Demonstrated knowledge and experience in healthcare medical billing, claims processing, follow-up, and appeals.
CareLogic EHR experience is strongly preferred.
Strong critical thinking, research, analytical, and mathematical skills.
Current knowledge of HIPAA compliance, 42 CFR requirements, and changing regulatory guidelines.
Strong proficiency with email, search engines, internet research, and payer websites.
Pay range of $23 to $27 per hour depending on experience.
Generous PTO.
403(b) retirement plan.
Educational assistance.
Medical, dental, and vision insurance.
Employee assistance programs.
Ongoing training, mentorship, career development, and advancement opportunities.
Supportive team culture guided by Humanity, Empowerment, Accountability, Respect, and Teamwork.
Certified Great Place to Work.
Location
Massachusetts, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
1 month ago