Medical Biller

Mental Health Private Practice Insurance and Billing Specialist

This role’s area of responsibility is with billing and insurance claims for a group therapy practice. We are seeking someone with experience that can ensure our claims are filed timely and correctly and keep our revenue cycle going. This role will monitor the EOB’s (explanation of benefits) to make sure the clinicians are paid according to contract guidelines. Biller will take appropriate action to get the claims paid as they should be. This may require phone calls, writing a letter of appeal to insurance companies, etc. Billing specialist will also keep track of outstanding claims making sure they are processed in a timely manner. This role will keep clinicians informed of any issues that arise such as co-pays changing, a deductible that was reached, any adjustment made that results in the deductible having to be met again, billing or reimbursement mistakes that result in money being recouped, or money being sent and an adjustment being made in the client’s favor.

Breathe Counseling is a recently expanded private practice that is fast growing with immense potential. Ideal candidates have strong experience with medical billing, organizational skills, and ability to follow up with billing/insurance via calls, emails, and letters in a timely and accurate manner. Our company values each team member and intentionally supports their personal and professional goals. We would love for you to join us in our mission and vision of walking with others on their healing, growth, and transformational journey.

Billing Specialist Responsibilities:

• Provide credentialing and enrollment for our clinicians (BCBS)
• Manage revenue cycle KPIs to optimal performance.
• Set up, monitor and follow up on getting required chart information prior to being scheduled for first session.
• Verify client insurance benefits and eligibility before they receive services using scheduling software, provider portal, phone, email etc.
• Check all calendar sessions prior to invoicing/claim creation to check for fee discrepancies.
• Create and submit insurance claims/superbills.
• Check claim response against chart and make any adjustments per insurance response. Document adjustments in Admin Note.
• Keep practice information up to date on all insurance portals.
• Gather EOB information and payment information off portals daily to reconcile payments in Simple Practice.
• Reconcile payments with what payments have come through Simple Practice monthly.
• Work to keep accounts receivable current continuously, keeping calendar reminders for payment plan charges as scheduled.
• Prepare and submit medical claims to insurance companies through billing software.
• Ensure patient information is correct and up to date.
• Verify CPT and ICD-10 codes are correct before claims are submitted.
• Ensure timely and accurate submission of claims.
• Claim generation/validation/submission via EHR (Simple Practice).
• Keep watch on the insurance claims to ensure they are being received processed.
• Monitor and follow up with insurance on any denials of claims as well as any unprocessed or unpaid claims.
• Investigate and appeal denied claims. Resubmit corrected claims.
• Monitoring and managing all denied and rejected medical claims for proper corrections and refiling.
• Maintain patient responsibility portions of the bill/patient invoices.
• Invoice and collect balance, co-pays/co-insurance and receive client payments, post to patient accounts, run patient statements, and credit card processing through our EHR (Simple Practice).
• Follow up on missed payments and resolve financial discrepancies.
• Collect and review referrals and prior authorizations using provider portals/phone/fax services.
• Prepare weekly and monthly reports for the Finance department.
• Attention to detail and time management to maintain workflow for a team of 8-10 counselors
• Monitor and respond to client billing/coding/insurance questions, keeping a record via admin note, and communicate with clinicians.
• Create/Send invoice and all Intensive paperwork to upcoming clients, record on chart in the Admin Note, keep an outside “table” of upcoming Intensive dates and who will attend to best keep track of payments, etc.

Qualifications:

• Required: Insurance and billing experience.
• Must be computer proficient, knowledge of EHR is mandatory.
• Ability to maintain confidential and meticulous records.
• Demonstrate exceptional organizational skills when performing typical clerical tasks such as answering phones, scheduling, preparing estimates, and collecting, posting payments.
• Must be dependable and skilled in quality control when handling financial information, performing insurance verification and preparing end of the day/week/month reports
• CPT/ICD 10 coding experience required; certification preferred.
• Experience with EHR Simple Practice

Job Type: 20-25 hrs per week

Pay: $21-$23 per hour

Schedule: (flexible) Monday-Friday, Day shift

Location: Hybrid

Join our dynamic team and make a difference in the lives of our valued clients - this is how we change the world, one regulate and well person at a time.

To apply, please submit your resume highlighting your relevant experience in medical billing and insurance.

Job Type: Part-time

Pay: $21.00 - $23.00 per hour

Expected hours: 20 – 25 per week

Benefits:

• Flexible schedule
• Paid time off

Schedule:

• Day shift
• Monday to Friday

Work setting:

• Hybrid work
• Private practice

Application Question(s):

• Do you have experience with the EHR Simple Practice?
• Do you have experience working in mental health private practice billing?

Work Location: Hybrid remote in Bloomington, IL 61701