About This Role
The Billing Specialist supports the organization's revenue cycle by collaborating with an outsourced medical billing company to ensure accurate and timely processing of insurance claims, payment posting, and reconciliation of reimbursements. This position manages electronic medical billing records, handles client intake and onboarding within the electronic medical record system, and acts as a key resource for insurance billing and collections.
Responsibilities
- Record and reconcile accounts receivable transactions across multiple payment platforms and merchants
- Assist with private pay billing for program services, including GOALS, therapeutic services, recreation therapy, and other program-related services
- Process client payments and maintain accurate payment records
- Research and resolve payment discrepancies, billing inquiries, and account balances
- Work collaboratively with Program Directors, Clinical Staff, and the Controller to ensure accurate billing and revenue recognition
- Support month-end billing and accounts receivable reconciliation processes
- Serve as a liaison between clients, the medical billing company, clinical providers, and program staff regarding billing matters, including claim denials, authorization expirations, billing issues, and payment questions
- Verify insurance eligibility and benefits prior to the initiation of services and as coverage changes occur
- Work directly with the medical billing company to ensure accurate claim submission, claim tracking, denial management, and resubmissions
- Monitor outstanding claims and assist in resolving denied, rejected, or underpaid claims
- Respond to client inquiries regarding insurance billing, benefits, claims, patient responsibility, deductibles, copayments, coinsurance, and payment arrangements
- Maintain accurate insurance information and client billing records in compliance with organizational policies and payer requirements
- Assist with insurance credentialing and recredentialing activities as assigned
- Monitor insurance authorization status for all clients and services within Central Reach to support uninterrupted service delivery
- Identify authorization discrepancies, data entry errors, and billing issues and make appropriate corrections or escalate concerns as needed
- Manage the Central Reach intake and onboarding process for new clients and staff
- Create and maintain client authorizations, staff assignments, and service connections within Central Reach
- Update and maintain insurance fee schedules, payer rates, and billing information in Central Reach
- Ensure client demographic, insurance, and authorization information remains accurate and current
- Monitor and coordinate the annual Continuation of Services Consent process and ensure required documentation is completed and maintained timely
