Medical Billing Clerk

Medical Billing Specialist – Behavioral Health

Full-Time | Temporary | Non-Exempt

Position Overview

We are seeking an experienced Medical Billing Specialist to support the billing and revenue cycle operations of a behavioral healthcare organization. This is an excellent opportunity for a detail-oriented billing professional who understands the complexities of behavioral health, mental health, and substance use disorder billing.

The Medical Billing Specialist will be responsible for submitting, tracking, correcting, and reconciling insurance claims while helping ensure timely and accurate reimbursement. This position works closely with clinical, intake, administrative, and leadership teams to resolve billing issues, maintain accurate records, and meet payer requirements.

Key Responsibilities

• Submit and manage claims to Medicare, Medicaid, Managed Care Organizations (MCOs), and commercial insurance carriers
• Verify patient insurance eligibility, coverage, and benefits
• Review clinical documentation to ensure services are accurately supported for billing
• Process corrected claims, resubmissions, reconsiderations, and appeals
• Monitor and follow up on unpaid, denied, rejected, and underpaid claims
• Research denials and billing discrepancies and work toward timely resolution
• Post payments and adjustments and assist with accounts receivable reconciliation
• Track prior authorizations and ensure services are billed in accordance with payer requirements
• Maintain accurate billing and patient account information within Electronic Health Record (EHR) and practice management systems
• Generate billing, collections, denial, and accounts receivable reports
• Assist with identifying trends affecting reimbursement and revenue cycle performance
• Maintain knowledge of behavioral health billing requirements and updates to CPT, HCPCS, and ICD-10 coding
• Communicate with insurance carriers regarding claim status, payment issues, denials, and billing requirements
• Collaborate with clinicians and administrative staff to resolve documentation and reimbursement issues
• Maintain compliance with applicable payer policies, billing regulations, and organizational procedures

Required Qualifications

• High school diploma or equivalent
• Minimum of 2 years of medical billing experience
• Previous experience billing for behavioral health, mental health, and/or substance use disorder services
• Working knowledge of CPT, HCPCS, and ICD-10 coding
• Experience billing Medicare, Medicaid, and commercial insurance
• Strong knowledge of claims processing, denial management, payment posting, and accounts receivable
• Experience working with EHR and/or medical practice management systems
• Proficiency with Microsoft Office, particularly Excel
• Strong attention to detail and ability to identify and resolve discrepancies
• Excellent organizational, analytical, communication, and follow-up skills
• Ability to manage multiple priorities and meet billing deadlines

Preferred Qualifications

• Associate's degree in Healthcare Administration, Business Administration, or a related field
• Certified Professional Biller (CPB) or similar billing certification
• Experience with Certified Community Behavioral Health Clinic (CCBHC) billing
• Knowledge of Rhode Island Medicaid and Managed Care billing requirements
• Experience with behavioral health EHR platforms such as Credible, CareLogic, Netsmart, Athenahealth, or similar systems

What We're Looking For

The ideal candidate is someone who enjoys digging into billing issues and getting them resolved. You should be comfortable researching denials, communicating with payers, reviewing documentation, and following claims through to payment.

Success in this position requires a combination of accuracy, persistence, organization, and strong knowledge of behavioral healthcare billing and reimbursement.

If you have hands-on behavioral health billing experience and are looking for a full-time temporary opportunity where your expertise can make an immediate impact, we encourage you to apply.

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