Experienced SUD/MH medical biller needed to join the revenue cycle management team. The role focuses on accurate and timely submission of behavioral health claims, including original and corrected claims, while ensuring billing aligns with payer requirements, authorizations, documentation, and internal billing guidelines.
This is an in-person position with potential for hybrid, but it is not a remote role.
Key responsibilities include:
- Prepare and submit accurate insurance claims for SUD and MH services.
- Ensure claims are submitted within payer timely filing limits.
- Review claims for accuracy, completeness, and proper billing information before submission.
- Submit corrected claims when billing errors or authorization changes are identified.
- Review census, demographic, insurance, authorization, and clinical information needed for claims.
- Coordinate with internal and external departments to resolve billing discrepancies.
- Use appropriate diagnosis codes, procedure codes, revenue codes, modifiers, and units.
- Monitor unbilled claims and address barriers to timely submission.
- Maintain documentation of billing activity and claim corrections.
- Follow payer-specific billing guidelines and assist with audits and quality reviews as needed.
Requirements & Qualifications
- Prior SUD and/or Mental Health medical billing experience required.
- Experience billing PHP and IOP services strongly preferred.
- Hands-on experience preparing and submitting institutional and/or professional behavioral health claims.
- Experience submitting corrected claims and resolving claim submission errors.
- Strong understanding of behavioral health billing, including CPT/HCPCS codes, revenue codes, ICD-10 diagnosis codes, modifiers, units, and payer requirements.
- Knowledge of insurance authorization requirements and their impact on claim submission.
- Understanding of payer timely filing requirements.
- Experience with KIPU and CollaborateMD strongly preferred.
- Strong attention to detail and ability to identify discrepancies before claims are submitted.
- Excellent organizational and time-management skills.
- Ability to manage a high-volume billing workload while maintaining accuracy.
- Ability to work independently and escalate issues appropriately.
Benefits & Perks
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Location
Massachusetts, US
Employment Type
Full-time
Experience Level
Intermediate Level
Salary Range
$55,000 - $55,000
Remote work allowed
No
Posted
1 month ago
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