What are the responsibilities and job description for the Billing Specialist position at Mental Health Assoc Southern Tier, Inc.?
JOB TITLE: Billing Specialist
CLASSIFICATION: Non-Exempt/Full-Time
HOURS: 40 Hours
SCHEDULE: Monday-Friday
REPORTS TO: Director of Finance & Operations
SUPERVISES: N/A
JOB SUMMARY: The Billing Specialist is responsible for managing the billing process, ensuring timely and accurate submission of claims to insurance companies, and handling client billing. This role is crucial in maintaining the financial health of the agency by ensuring that payments are processed efficiently and in compliance with insurance regulations and mental health billing practices. The Billing Specialist will have experience with healthcare billing, a strong understanding of insurance procedures, and excellent communication skills to work with clients and insurance providers. Familiarity with mental health services is a plus.
DUTIES AND RESPONSIBILITIES:
- Prepare and submit insurance claims for mental health services (NYS Office of Mental Health, OMH), ensuring accuracy and adherence to regulatory guidelines (e.g., HIPAA).
- Track and follow up on outstanding claims, rejections, and denials, working with insurance companies to resolve issues.
- Maintain up-to-date knowledge of mental health billing codes (e.g., CPT, ICD-10) and insurance procedures for claims submission.
- Process and post payments received from insurance companies, and other payers.
- Monitor accounts receivable and ensure timely collection of payments.
- Maintain detailed records of billing activities, payments, adjustments, and balances.
- Reconcile accounts and ensure accurate account statuses in the billing system.
- Utilize billing software and Electronic Health Records (EHR) systems to track, process, and manage client billing.
- Maintain and update client information, insurance details, and service records in the system.
- Generate reports on billing status, payments, and accounts receivable for internal use.
- Able to identify, report, and assist with the return of overpayments in accordance with regulatory requirements.
- Ensure all billing procedures comply with relevant federal and state regulations, including mental health-specific policies.
- Maintain confidentiality of client information in compliance with HIPAA and agency policies.
- Stay updated on changes in billing regulations and payer requirements, adjusting procedures as needed.
- Work closely with therapists and administrative staff to ensure accurate billing and coding for services provided.
- Communicate with insurance companies, clients, and staff regarding billing questions, denials, and payment discrepancies.
- Assist in the coordination of financial reports and audits when necessary.
Client Billing & Payments (60%)
Compliance & Documentation (30%)
Other (10%)
REQUIRED QUALIFICATIONS:
- Associate’s or Bachelor’s degree in accounting, healthcare administration, or related field
- Previous experience in medical or mental health billing, with a strong understanding of insurance claims processes
- Familiarity with mental health billing codes, including CPT and ICD-10, is preferred
- Two or more years of professional/executive office management experience
- Successfully complete all required background and reference checks
- Complete all state/agency required trainings during orientation period, and annually, as required
- Maintain strict confidentiality
- Support the mission and vision of MHAST
KNOWLEDGE/SKILLS/ABILITIES:
- Understanding and sensitivity to support a diverse employee and client population (race, religion, gender identity, sexual orientation, ethnicity, etc.)
- Ability to multi-task between multiple priorities and projects
- Proficiency in Microsoft Office, Google applications, ability to learn new platforms/systems
- Ability to be professional
- Excellent organizational skills, detail-oriented
- Excellent communication skills (verbal, written)
WORKING CONDITIONS:
- Office Setting
- Some exposure to cleaners, chemicals is expected
- Physical requirements include walking, bending, standing, climbing stairs, and lifting (light/medium-up to 50 pounds)
- Travel may be required for external meetings/trainings/events or travel between MHAST locations
This job description is a summary of the typical job functions; it is not a comprehensive list of all possible responsibilities and duties. Tasks may differ from what is outlined in the job description and other duties may be assigned as needed. The job description may be amended at any time at the discretion of MHAST.
MHAST is an Equal Opportunity Employer. We are committed to employment practices that are inclusive and represent a diverse workforce. MHAST is also committed to employ individuals with lived experiences, both mental health and substance use disorder experiences. Peers with lived experience are representative of the population served in MHAST programs and their work within the mental health field has been proven to be a pivotal part of the success and recovery of others.
REQUIRED QUALIFICATIONS:
- Associate’s or Bachelor’s degree in accounting, healthcare administration, or related field
- Previous experience in medical or mental health billing, with a strong understanding of insurance claims processes
- Familiarity with mental health billing codes, including CPT and ICD-10, is preferred
- Two or more years of professional/executive office management experience
- Successfully complete all required background and reference checks
- Complete all state/agency required trainings during orientation period, and annually, as required
- Maintain strict confidentiality
- Support the mission and vision of MHAST