Job Title

Express Employment is seeking a medical billing and collections specialist for an addiction treatment facility. Job duties include: Batching and submitting insurance claims electronically via billing platform and/or payer portal Ensuring billing accuracy and efficiency, and resolving payer rejections/denials swiftly for services provided to patients and clients Reviewing information from electronic medical records in patient account to ensure preparation and submission of clean claims Generating and submitting claims to insurance companies, government programs, and other payers for services provided to patients and clients Resolving rejected electronic claims so that current submission is successful and future submissions are not rejected Promptly resolving rejected claims for timely resubmission Conducting regular follow-up with insurance companies on claims statuses Manually processing any claims that are not eligible for electronic submission Reviewing and following up on unbilled appointments in the system daily Ensuring compliance with relevant healthcare regulations and HIPAA, and staying up-to-date with changes in billing and reimbursement guidelines Collaborating with other departments, such as clinical staff and administrative teams, to resolve billing and payment issues and improve processes Collaborating with RCM team and other departments to ensure successful execution of assigned duties and priorities Maintaining confidentiality in accordance with established policies and procedures and standards of care Adhering to all company policies and procedures Performing other job-related duties as assigned Requirements: 3+ years of medical billing experience in a healthcare system required 2+ years of experience in billing, payer relations, or medical A/R 1+ years of experience in substance use disorder and/or mental health setting preferred Experience working with commercial medical insurance billing, claims submission, and the technical aspects of billing software Must be proficient with HCPCS/CPT, ICD-10 Coding, DSMS and ASAM criteria, and various data entry systems for 3rd party billing and payers, and their reimbursement and denial patterns Ability to work well in a team environment with the ability to triage priorities, delegate tasks if needed, and handle conflict Problem-solving skills to research and resolve discrepancies, denials, appeals, collections KIPU or similar EHR/EMR experience preferred Knowledge of CMS and third-party payer regulations and guidelines Strong understanding of insurance billing and coding requirements Working knowledge billing and reimbursement requirements by payer Other details: Schedule is Monday-Friday, 8am-5pm