Personal Growth Counseling Services

Compensation

Full Description

Salary: Position Overview We are seeking a detail-oriented and experienced Billing Specialist to join our inclusive and affirming mental health practice. This position is essential to maintaining a smooth revenue cycle through accurate claims processing, efficient billing operations, and proactive communication with payers and clients. The ideal candidate will have a strong understanding of mental health billing procedures, including Ohio Medicaid, and will be comfortable working independently in a remote setting. Key Responsibilities Claims Processing & Revenue Cycle Management • Correct and submit unbilled claims due to missing diagnostic codes, signatures, or pending statuses. • Monitor claim status and follow up on rejections or denials; resubmit and appeal as needed. • Contact payers regarding overpayments, underpayments, and recoupments within 30 days of identification. • Process insurance write-offs for issues such as duplicates or payer errors. • Update and maintain billing rules with the Revenue Cycle Management (RCM) vendor to improve billing efficiency. Client Billing & Accounts Management • Ensure client demographic and insurance information is accurate and current in the EHR system. • Perform monthly insurance verifications for active clients. • Address client billing inquiries professionally and provide timely resolution. • Manage accounts receivable and support collections activity as needed. • Maintain accurate billing logs, internal billing notes, and documentation in compliance with agency policies. Collaboration & Compliance • Collaborate with clinical staff to ensure documentation and coding support timely and accurate billing. • Ensure compliance with Ohio Administrative Code (OAC), Ohio Revised Code (ORC), Medicaid requirements, and HIPAA standards. • Stay informed of Ohio Medicaid policy updates and implement necessary billing adjustments. • Support financial audits, compliance checks, and credentialing-related billing reviews. Reporting & System Management • Utilize ClinicTracker (EHR) to process claims and track financial data. • Generate, review, and submit regular reports to monitor revenue performance and billing trends. Credentialing & Provider Enrollment • Assist with credentialing individual providers with Ohio Medicaid and private insurance carriers. • Track and maintain credentialing application statuses, revalidations, and renewals. • Collaborate with providers and administrative staff to ensure timely submission of credentialing paperwork. • Maintain accurate records of credentialing documentation in compliance with payer and regulatory requirements. • Communicate with carriers to resolve credentialing or enrollment-related issues affecting billing or reimbursement. Qualifications • Minimum 2 years of experience in medical billing, preferably in behavioral health or mental health services. • Strong understanding of Ohio Medicaid billing guidelines and third-party insurance claim processes. • Proficiency in EHR systems such as ClinicTracker, CareLogic, or inSync • Working knowledge of CPT/ICD-10 coding, insurance authorization, and HIPAA compliance. • Excellent communication and interpersonal skills. • High level of accuracy, attention to detail, and ability to meet deadlines. • Comfortable using inclusive, affirming, and culturally responsive language. • Must meet all privacy and security requirements for remote work.