Medical Billing Specialist

Job Summary

The Behavioral Health Billing Specialist is responsible for accurate and timely billing, claims submission, payment posting, and follow-up for behavioral health services. This role ensures compliance with payer requirements, state and federal regulations, and organizational policies while maximizing reimbursement and minimizing denials.

Key Responsibilities

• Prepare, submit, and manage claims for behavioral health services (mental health and/or substance use treatment) to Medicaid, Medicare, and commercial insurance payers

• Verify patient insurance eligibility, benefits, authorizations, and coverage requirements

• Ensure services are billed accurately using appropriate CPT, HCPCS, ICD-10, and place-of-service codes

• Review clinical documentation to support prior authorization submissions and ensure compliance with payer authorization guidelines.

• Post payments, adjustments, and denials accurately in the billing system

• Identify, research, and resolve claim denials, underpayments, and rejections

• Submit appeals and corrected claims as necessary within payer deadlines

• Monitor accounts receivable and follow up on outstanding claims to ensure timely reimbursement

• Communicate effectively with clinicians, supervisors, and insurance representatives regarding billing issues

Required Qualifications

• High school diploma or equivalent

• Minimum of 1–2 years of medical billing experience, preferably in behavioral or mental health

• Knowledge of behavioral health billing codes, modifiers, and documentation requirements

• Familiarity with Medicaid, Medicare, and commercial insurance billing processes

• Experience with electronic health record (EHR) and practice management systems

• Strong attention to detail and accuracy

• Ability to manage multiple tasks and meet deadlines

Preferred Qualifications

• Experience billing behavioral health and mental health services, including SAIOP, SACOT, and Peer Support. Experience with inpatient billing for facility-based crisis services, residential treatment, and detoxification is preferred but not required.

Skills & Competencies

• Strong analytical and problem-solving skills

• Excellent written and verbal communication skills

• Ability to work independently and as part of a team

• Confidentiality and professionalism when handling sensitive patient information

• Proficiency in Microsoft Office (Excel, Word)

Pay: $14.00 - $18.00 per hour

Expected hours: 40.0 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: In person

Salary : $14 - $18