The Billing Specialist supports the organization's revenue cycle by working with an outsourced medical billing company to ensure accurate and timely processing of insurance claims, payment posting, and reimbursement reconciliation. The role also maintains electronic medical billing records, supports client intake and onboarding in the EHR system, and serves as a key resource for insurance billing and collections.
The position monitors denied, rejected, and unpaid claims across multiple insurance carriers, coordinates with billing, clinical, and client-facing teams to resolve issues, and helps maximize reimbursement. It also handles patient account collections, including statements, payment arrangements, and responses to billing inquiries.
In addition, the role supports private-pay and third-party payer billing, insurance benefit verification, authorizations, client and insurance record maintenance, and ongoing compliance with payer and organizational requirements.
Accounts Receivable & Client Billing
- Record and reconcile accounts receivable transactions across multiple payment platforms and merchants.
- Assist with private pay billing for program services, including GOALS, therapeutic services, recreation therapy, and other program-related services.
- Process client payments and maintain accurate payment records.
- Research and resolve payment discrepancies, billing inquiries, and account balances.
- Work collaboratively with Program Directors, Clinical Staff, and the Controller to ensure accurate billing and revenue recognition.
- Support month-end billing and accounts receivable reconciliation processes.
Insurance Billing & Revenue Cycle Management
- Serve as a liaison between clients, the medical billing company, clinical providers, and program staff regarding billing matters, including claim denials, authorization expirations, billing issues, and payment questions.
- Verify insurance eligibility and benefits prior to the initiation of services and as coverage changes occur.
- Work directly with the medical billing company to ensure accurate claim submission, claim tracking, denial management, and resubmissions.
- Monitor outstanding claims and assist in resolving denied, rejected, or underpaid claims.
- Respond to client inquiries regarding insurance billing, benefits, claims, patient responsibility, deductibles, copayments, coinsurance, and payment arrangements.
- Maintain accurate insurance information and client billing records in compliance with organizational policies and payer requirements.
- Assist with insurance credentialing and recredentialing activities as assigned.
Authorization & Central Reach Administration
- Monitor insurance authorization status for all clients and services within Central Reach to support uninterrupted service delivery.
- Identify authorization discrepancies, data entry errors, and billing issues and make appropriate corrections or escalate concerns as needed.
- Manage the Central Reach intake and onboarding process for new clients and staff.
- Create and maintain client authorizations, staff assignments, and service connections within Central Reach.
- Update and maintain insurance fee schedules, payer rates, and billing information in Central Reach.
- Ensure client demographic, insurance, and authorization information remains accurate and current.
- Monitor and coordinate the annual Continuation of Services Consent process and ensure required documentation is completed and maintained timely.
Compliance & Administrative Support
- Maintain confidentiality of client, financial, and insurance information in accordance with HIPAA and organizational privacy policies.
- Ensure billing and documentation practices comply with payer regulations, contractual requirements, and organizational policies.
- Maintain organized billing records and documentation to support audits, payer reviews, and internal reporting.
- Assist with special projects, process improvements, reporting, and other duties as assigned.
Location
Florida, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
2 weeks ago