Overview
The Outpatient Mental Health Clinic Billing Specialist is responsible for managing the billing and reimbursement process for behavioral health services. This position ensures accurate claim submission, payment posting, insurance verification, denial management, and compliance with federal, state, and payer regulations. The Billing Specialist works closely with clinicians, administrative staff, insurance companies, and patients to maximize revenue cycle efficiency and maintain excellent customer service.
Responsibilities
- Process and submit electronic and paper claims for outpatient mental health and behavioral health services.
- Verify patient insurance eligibility, benefits, authorizations, and coverage requirements.
- Review clinical documentation for billing accuracy and compliance with payer guidelines.
- Ensure proper use of CPT, ICD-10, HCPCS, and modifier coding related to mental health services.
- Monitor and follow up on unpaid, denied, rejected, or underpaid claims.
- Investigate and resolve billing discrepancies and insurance issues in a timely manner.
- Verify insurance and patient payments accurately into the electronic health record (EHR) and practice management systems.
- Assist patients with billing questions.
- Establish and monitor payment plans when applicable.
- Maintain accounts receivable and work aging reports to improve collection rates.
- Communicate with insurance companies regarding claim status, appeals, and reimbursement issues.
- Prepare and submit claim appeals with supporting documentation.
- Maintain confidentiality and compliance with HIPAA, payer contracts, and organizational policies.
- Assist with month-end reporting, audits, and revenue cycle analysis.
- Stay current with behavioral health billing regulations, reimbursement policies, and coding updates.
Qualifications
Education:
- High school diploma or equivalent required.
- Associate degree in Healthcare Administration, Medical Billing and Coding, or related field preferred.
Experience:
- Minimum of 2 years of medical billing experience required.
- Experience with behavioral health, mental health, or substance use disorder billing preferred.
- Experience working with Medicare, Medicaid, commercial insurance, and managed care plans preferred.
- Experience with SimplePractice and/or Ritten is a plus.
Knowledge, Skills, and Abilities:
- Knowledge of mental health billing practices, CPT and ICD-10 coding.
- Understanding of insurance verification, prior authorization, claims processing, and denial management.
- Proficiency with electronic health record (EHR) and billing software systems.
- Strong attention to detail and organizational skills.
- Excellent written and verbal communication skills.
- Ability to manage multiple priorities and meet deadlines.
- Strong problem-solving and analytical abilities.
- Ability to maintain confidentiality and professionalism when interacting with patients and staff.
Physical Requirements
- Prolonged periods of sitting and computer work.
- Ability to communicate effectively by phone, email, and in person.
- Occasional lifting of office materials up to 15 pounds.
Work Environment
- Office-based outpatient mental health clinic setting.
- May involve interaction with patients experiencing behavioral health challenges.
- Standard business hours
- Working from clinic 5 days/week
Key Performance Indicators (KPIs):
- Clean claim submission rate
- Days in accounts receivable
- Denial resolution rate
- Collection percentage
- Payment posting accuracy
- Timely claim filing compliance
This position plays a critical role in ensuring the financial health of the clinic while supporting access to quality mental health services for patients.
This ad will close on Monday, Aug 24, 2026. Call backs will take place by Friday, August 28th with an ideal start date of 10/1/26.
Pay: $31.00 - $34.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Retirement plan
- Vision insurance
Work Location: In person
