JOB SUMMARY
The Medical Biller is responsible for accurate and timely billing for behavioral health, peer support, medical, and other services provided by Dynamic Recovery. This position manages claims submission, payment posting, insurance follow-up, denials, prior authorization tracking, and billing-related client account questions. The Medical Biller works closely with clinical, administrative, and program staff to support compliant documentation and maximize appropriate reimbursement while maintaining strict confidentiality and HIPAA compliance.
Position Performance Requirements:
- Claims Submission: Prepare, review, and submit accurate claims to Medicaid, Medicare, commercial insurance, and other payers in accordance with payer requirements and established billing timelines.
- Billing Accuracy: Verify client demographics, insurance coverage, authorizations, provider information, diagnosis codes, procedure codes, modifiers, units, and other required claim information prior to submission.
- Payment Posting: Post insurance payments, adjustments, denials, and client payments accurately and reconcile payments with remittance advice and electronic remittance information.
- Accounts Receivable: Monitor outstanding claims and accounts receivable, identify unpaid or underpaid claims, and complete timely payer follow-up.
- Denials and Appeals: Research denied or rejected claims, correct billing errors, resubmit claims, and assist with appeals or reconsiderations when appropriate.
- Prior Authorizations: Track prior authorization requirements, authorization numbers, approved units, effective dates, and service limits; communicate authorization issues to appropriate staff.
- Insurance Verification: Verify eligibility and benefits as needed and identify changes in client coverage that may affect billing.
- Documentation Review: Review records for billing readiness and communicate missing, incomplete, or inconsistent documentation to appropriate staff without altering clinical documentation.
- Billing Inquiries: Respond professionally to billing questions from clients, staff, payers, and other authorized parties and assist with resolving account discrepancies.
- Compliance: Follow applicable federal and state billing requirements, payer policies, organizational procedures, and fraud, waste, and abuse prevention standards.
- Reporting and Reconciliation: Maintain accurate billing records and assist with billing reports, reconciliation, audits, and financial tracking as requested.
- Collaboration: Work closely with clinical, medical, peer support, front desk, and administrative staff to support accurate service capture and timely reimbursement. Establish and maintain productive working relationships with fellow employees, supervisors, and the public.
- Confidentiality: Handle sensitive client and financial information with discretion. At all times maintain strict adherence to Federal and State Confidentiality Laws and HIPAA regulations.
Education Requirements:
- High school diploma or equivalent required; associate or bachelor’s degree in business, healthcare administration, accounting, or a related field preferred.
- Medical billing or healthcare revenue cycle experience preferred, with behavioral health billing experience strongly preferred.
- Working knowledge of insurance claims, EHR/billing systems, Medicaid and other payer requirements, or an equivalent combination of education and experience.
Initial Employment:
Evaluations will be conducted by the Business Director on an ongoing basis during the initial 6-month probationary period. Position eligible for paid time off and sick leave following probationary period, and organizational holidays immediately in accordance with Dynamic Recovery’s personnel policies.
Job Types: Full-time, Part-time
Pay: $16.00 - $22.00 per hour
Benefits:
- Flexible schedule
- Life insurance
- Paid time off
- Professional development assistance
- Retirement plan
People with a criminal record are encouraged to apply
Application Question(s):
- Do you have a degree or experience working in a medical or behavioral health setting?
Experience:
- Billing and Coding : 1 year (Preferred)
Work Location: In person
