Medical Billing Specialist

About Aurora Counseling Associates

Aurora is a dynamic and expanding private mental health practice that specializes in providing top-notch therapeutic counseling services to children, adolescents, adults, and couples. With a focus on mindfulness-based strategies and a holistic wellness approach, we strive for balance in mind, body, and spirit to foster a clear mind for a healthy life — for both our clients and our employees.

Our practice is built around community and inclusion. Our revenue cycle team is central to how we deliver care: clean, timely billing is what allows our clinicians to focus on clients instead of paperwork, and what keeps costs predictable for the families we serve.

Position Summary

We are seeking a full-time Medical Billing Specialist with hands-on Massachusetts commercial behavioral health billing experience. This is a full-cycle role with real ownership: you will run claim submission through final resolution, work rejections and denials, apply payments, collect client balances, and own the aging A/R for a growing multi-clinician outpatient practice. You will report to the Practice Admin Director and work closely with our intake, credentialing, and clinical teams.

This role suits someone who is genuinely good at chasing a denial to its root cause rather than resubmitting and hoping. If you like clean A/R, tight cadences, and being trusted to run your own worklist against clear targets, you'll do well here.

What You'll Own

Daily

• Claim submission: Create, validate, and submit all electronic claims with locked notes. Every claim in 'ready' status is created, validated, and submitted within 24 hours.
• Rejections: Review, correct, and resubmit all rejected claims the same day. Corrections are made in the client's profile — not only on the claim — so the same error doesn't recur on future claims.
• Denials: Review all denied claims daily. Research the denial reason, correct and resubmit, or open an appeal. Contact clients directly where the denial requires their input, such as a missing coordination of benefits.
• Payment accuracy: Review paid claims against contracted rates and flag anything that doesn't reconcile.
• Copay collection: Collect outstanding copays for paid claims by charging cards on file. Where no valid card exists, add the client to the follow-up list and begin outreach.
• Overpayments: Review overpaid invoices, verify copay amounts against the client profile, correct the profile where the EOB adjusted the copay, and issue refunds as needed.
• Client response: Respond promptly and professionally to client questions about billing, reimbursements, and account discrepancies.

Weekly

• A/R follow-up: Work the aging revenue report from oldest and largest balance down, using payer portals and phone follow-up. Every claim aged over 60 days is documented with outreach date, findings, and next follow-up timing, and is revisited at least every two weeks until paid. This is the largest single block of the role.
• Client account tracker: Work the tracker for missing or declined cards, denial information needing client input, and incomplete claim or profile data. Clients are contacted daily until resolved, with notes kept current.

○ Outreach by phone, email, and text, including sending the credit card authorization form. After two unsuccessful attempts, notify the treating clinician and request their assistance.

○ Where insurance information is missing or wrong, remind clients of the Financial Agreement and that sessions will be billed at full rate until the information is corrected.

○ Follow practice cancellation guidelines where a client balance exceeds $250 and the client is unresponsive; coordinate with the Practice Admin Director on balances over $250 where the client is engaged.

• Paper claims: Submit all paper claims within one week and update claim status in the system.
• Manual EOBs: Apply all manually received EOBs — scanned, mailed, emailed, or received through payer payment vendors — within one week, collecting any adjusted copays and writing off the approved-versus-billed difference.
• Look-ahead: Review upcoming appointments for clients without a valid card on file, and review the payment dashboard for failed charges and expired cards, so problems are solved before the session rather than after.

Monthly

• Client statements: Generate and send monthly statements for designated client accounts.
• Collections coordination: Work with our collections partner on outstanding client accounts.
• Leadership review: Meet with practice leadership to review aging A/R, invoice, and claims reporting.

Ad Hoc

• Support additional follow-up and cleanup efforts as directed by the Practice Admin Director or Owners. Where ad hoc work cannot fit within the normal workweek alongside base activities, raise prioritization with the Practice Admin Director rather than letting core work slip.

What Success Looks Like

We measure this role on clear, specific standards. You will know exactly how you're doing:

• No aging A/R over 60 days
• No client invoice balance over 60 days
• 100% of claims submitted within one week
• All denials addressed within one week

Massachusetts Payer Knowledge (Required)

This role requires practical, current familiarity with the Massachusetts behavioral health payer landscape. You should be comfortable working directly in these payers' provider portals and know their behavioral health quirks:

• Blue Cross Blue Shield of Massachusetts
• Point32Health — Harvard Pilgrim Health Care and Tufts Health Plan, across commercial and Medicare product lines
• Mass General Brigham Health Plan
• Optum / United Behavioral Health, Aetna, and Cigna / Evernorth Behavioral Health
• Familiarity with Massachusetts behavioral health parity requirements, MassHealth prior authorization rules, and standardized Mass Collaborative forms is a plus.

Qualifications

• 2 years of medical billing experience, with at least 1 year in behavioral health or a mental health practice setting.
• Demonstrated experience billing Massachusetts commercial payers.
• Working knowledge of outpatient behavioral health CPT coding, including 90791 (intakes), 90832/90834/90837 (individual psychotherapy), 90846/90847 (family), 90853 (group), E/M codes 99202–99215 and 99417 for medication management, and 96130–96139 psychological testing codes, plus applicable modifiers and place-of-service codes.
• Demonstrated ability to work denials and A/R independently, including researching root cause, drafting appeals, and documenting follow-up so someone else could pick up the file.
• Comfortable working independently in an EHR and practice management system and in clearinghouse portals. Experience with IntakeQ / PracticeQ is preferred; experience with a comparable behavioral health platform is acceptable if you learn systems quickly.
• Solid Excel skills — filtering, pivot tables, and reconciling reports against payer remittances.
• Genuinely strong client-facing communication. A significant part of this role is calling and texting clients about cards, balances, and insurance problems. You need to be persistent and warm at the same time.
• Meticulous attention to detail, and the discipline to fix the root cause in the client profile rather than patching the individual claim.
• Working knowledge of HIPAA and a track record of handling PHI appropriately.

Preferred

• Prior experience in a multi-site or multi-state group practice.
• Experience with payer credentialing, revalidations, and CAQH maintenance.
• Experience with telehealth billing rules and modifier requirements across MA payers.
• Experience working secondary insurance and coordination of benefits.

Compensation and Benefits

• Employment Type: Full-time W2 position, approximately 30-40 hours per week. Remote or Hybrid.
• Benefits: Comprehensive health insurance and paid sick leave for full-time employees. Paid holidays, paid time off, and company-paid professional development.
• Schedule: Standard business hours, Monday through Friday, with availability during payer business hours for phone follow-up.
• Professional Growth: In-house training and company-paid continuing education toward billing and coding certification. Real opportunity to grow into a senior or lead revenue cycle role as our practice expands.

Why Join Aurora?

• Competitive pay and benefits, including medical benefits for full-time employees, paid sick time, and company-paid professional development.
• Be part of a supportive, interdisciplinary team passionate about mental health.
• Benefit from our tech-enabled systems and processes — a full suite of tools and a team of administrative professionals, so you can focus on resolving claims instead of fighting your software.
• Clear standards and clear feedback. You will always know what the targets are and where you stand against them.
• Contribute to a practice that values diversity and inclusivity across all cultures, races, religions, and gender expressions. Help influence our team culture as we expand into new geographies to bring more access to care.

Aurora Counseling Associates is an equal opportunity employer committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Pay: $20.00 - $25.00 per hour

Expected hours: No less than 30.0 per week

Benefits:

• Health insurance

Work Location: Hybrid remote in Natick, MA 01760

Salary : $20 - $25