Billing Specialist

POSITION TITLE:
Billing Specialist
REPORTS TO:
Business Office Manager
FLSA STATUS: Exempt
SCHEDULE: Monday–Friday, 8:00AM-5:00PM

POSITION SUMMARY

All Together Recovery LLC (ATR), provides multiple levels of ASAM SUD/BHSO care, including recovery housing, education, job training, employment, and other recovery related extensions to the family in for-profit and non-profit environments. The Billing Specialist is responsible for accurately preparing, submitting, and tracking billing claims and payments. This role ensures timely reimbursement by maintaining compliance with payer regulations, resolving billing discrepancies, and supporting overall revenue cycle operations. The Billing Specialist works closely with clinical, administrative, and financial teams to ensure accurate documentation, efficient workflows, and excellent customer service.

KEY PERFORMANCE INDICATORS (KPIs)

The Billing Specialist’s performance will be evaluated based on the following measurable outcomes:

Billing & Claims Management

• Prepare and submit
  initial claims to insurance payers
  
  • KPI: 100% of claims submitted within 24 hours

• Follow up on outstanding, denied, or rejected claims
  
  • KPI: 100% of denied and rejected claims resubmitted within 48 hours

• • KPI: 100% of claims worked within daily productivity

• Process adjustments, re-bills, and corrections as needed

• • KPI: <98% of claims reconciled with insurance payments

• Maintain organized records of all billed and pending claims

• • KPI: <98% of claims in the correct payer status

Payment Posting & Reconciliation

• Accurately post payments, adjustments, and remittances

• • KPI: 100% of EOB/ERAs posted accurately

• Research and resolve payment discrepancies, underpayments, and overpayments

• • KPI: <98% of payment issues resolved accurately

• Reconcile daily, weekly, and monthly billing reports to ensure accuracy

• • KPI: 100% of billing reports submitted to Business Office Manager

Administrative & Miscellaneous

• Scan, organize, and maintain digital and physical correspondence including EOBs, denials, approvals, and payer letters

• • KPI: 100% of correspondence sorted

• Prepare and mail invoices and other correspondence to patients and guarantors

• • KPI: 100% of invoices mailed monthly

• Assist with answering incoming phone calls and direct to appropriate departments

• • KPI: 100% of phone calls answered

• Assist with other duties as assigned by Business Office Manager

ADDITIONAL PERFORMANCE EXPECTATIONS

These align with the qualitative aspects of the role but should be reflected in regular evaluations:

• Demonstrates leadership and integrity in all interactions.

• Models servant leadership and fosters a culture of recovery and respect.

• Engages in continuous quality improvement for daily office operations.

SUPERVISORY RESPONSIBILITIES

This position has no supervision responsibilities.

BACKGROUND/EDUCATION

• The applicant must have a minimum of a high school diploma or GED.

• Minimum of 2-3 years’ experience working in billing, revenue cycle, or another related field preferred.
  An associate degree is preferred but not required.

• Experience working in behavioral health field preferred.

• Previous experience working with KIPU, CollabMD, Availity, and KYMMIS
  preferred.

QUALIFICATION REQUIREMENTS

Must have knowledge of medical privacy and confidentiality (Health Insurance Portability and Accountability act (HIPAA); computer applications/software to include Microsoft Office programs/MS outlook (e-mail), and internet familiarity, along with Dropbox and EHR is preferred.

Experience working with individuals and families who have various mental, behavioral, and substance use conditions.

SKILLS REQUIRED

WORKING CONDITIONS

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to
enable individuals with disabilities to perform the essential functions.

Must be able to sit, stand, bend, reach overhead and lift to 50 pounds; travel outside the office and/or attend meetings both during and after normal work hours, both at and away from the worksite. Exerting up to 50 pounds of force occasionally or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body. May involve walking or standing for brief periods of time. Requires about 3 hours of sitting and no more than 5 hours of standing or walking in an 8-hour workday.

Environmental Conditions:

The employee will work in an office setting with central heating and air. Some travel between facilities may be required.

Mental Demands:

There are several daily deadlines associated with this position, which may cause significant levels of stress for some individuals. The position will work with clients, staff, and family members on a variety of issues.

WORK EXPECTATIONS:

AT-WILL EMPLOYER STATEMENT:

ATR is an At-Will employer. This means that regardless of any provision on this form, the company or employee may terminate the employment relationship at any time, for any reason, with or without cause or notice. Nothing in this job description or in any document or statement, written or oral shall limit the right to terminate employment at-will.

No officer, employee or representative of the company is authorized to enter into an agreement -express or implied-with any employee for employment for a specified period unless such an agreement is in a written contract signed by the managing partner of the company.