Third Party Billing Specialist – Administration

The Third Party Billing Specialist is a key member of the Billing Department, responsible for ensuring the accurate submission and timely collection of insurance and self-pay receivables across a diverse payer mix. This role serves as the primary liaison between the organization and third-party payers, including MassHealth, MassHealth MCOs, Medicare and Medicare MCOs, and commercial payers, candidate must possess a thorough working knowledge of mental health and/or medical billing regulations and payer requirements.

Core responsibilities encompass the full revenue cycle: obtaining prior authorizations, verifying insurance coverage, submitting clean claims in a timely manner, and resolving pre-billing and daily claim rejections. The Specialist monitors both insurance and self-pay aging reports to identify reimbursement trends and address outstanding balances, while maintaining accurate daily payment posting for client and insurance payments. Client data integrity is upheld through diligent entry and maintenance of records within the electronic billing system.

The ideal candidate brings a minimum of 2 – 3 years of experience in mental health or medical billing and third-party accounts receivable management, along with proficiency in Microsoft Office applications. Strong attention to detail, the ability to prioritize in a fast-paced environment, and a commitment to remaining current with evolving billing rules and regulations are essential to success in this role. The Specialist is expected to adhere to established organizational procedures and protocols and to operate within appropriate reporting structures at all times.

In addition to very competitive salaries LUK offers a substantial and unique benefit package found here.