Billing & Insurance Specialist

We are seeking an experienced, detail-oriented Billing and Insurance Specialist with a background in facility-based mental health and substance use disorder billing.

This role combines medical billing, insurance reimbursement, patient account management, and financial operations. You will work closely with insurance, finance, admissions, and clinical operations teams to ensure claims, insurance payments, patient payments, and account balances are processed and reconciled accurately.

You will report directly to the Executive Director of Admissions and Insurance.

What you’ll do

• Manage mental health billing for facility-based mental health and substance use disorder services, including PHP and IOP levels of care.
• Process and review insurance claims to ensure accurate submission with correct patient, provider, facility, service, and billing information.
• Support out-of-network claims, including claim status review, reimbursement, patient responsibility, and payment discrepancy resolution.
• Review EOBs and insurance reimbursement details, including denials, adjustments, deductibles, coinsurance, and other claim determinations.
• Post insurance payments and accurately record reimbursement information in patient accounts.
• Research unpaid, underpaid, denied, rejected, or incorrectly processed claims and assist with follow-up and resolution.
• Support denials, reconsiderations, appeals, and related documentation.
• Respond to patient and guarantor questions about invoices, payments, balances, credits, and discrepancies.
• Maintain accurate documentation by scanning, labeling, uploading, and organizing insurance correspondence, EOBs, checks, and billing documents.
• Collaborate with finance, insurance, admissions, and other departments on outstanding claims, patient balances, payment issues, and reconciliation matters.