Behavioral Health Outpatient Billing Specialist

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Prepare, submit, and oversee claims for behavioral health services to Medicaid, Medicare, and commercial insurance providers.

• Verify patient insurance eligibility, benefits, authorizations, and coverage specifications.

• Ensure that services are billed correctly using the appropriate CPT, HCPCS, ICD-10, and place-of-service codes.

• Review clinical documentation to support prior authorization requests and ensure adherence to payer authorization standards.

• Accurately post payments, adjustments, and denials in the billing system.

• Identify, investigate, and resolve claim denials, underpayments, and rejections.

• Submit appeals and corrected claims within the deadlines set by payers.

• Monitor accounts receivable and follow up on outstanding claims to guarantee prompt reimbursement.

• Communicate effectively with clinicians, supervisors, and insurance representatives regarding billing concerns.

• Ensure compliance with payer requirements, state and federal regulations, and organizational policies while optimizing reimbursement and reducing denials.

⛳️ Requirements

• High school diploma or equivalent.

• At least 1–2 years of medical billing experience, preferably in behavioral or mental health.

• Knowledge of behavioral health billing codes, modifiers, and documentation necessities.

• Familiarity with the billing processes for Medicaid, Medicare, and commercial insurance.

• Experience with electronic health record (EHR) and practice management systems.

• Strong attention to detail and accuracy.

• Ability to manage multiple tasks and adhere to deadlines.

• Strong analytical and problem-solving abilities.

• Excellent written and verbal communication skills.

• Ability to work both independently and collaboratively within a team.

• Maintain confidentiality and professionalism when handling sensitive patient data.

• Proficiency in Microsoft Office (Excel, Word).

• Experience with outpatient behavioral health billing is preferred.

• Previous experience billing for Intensive Outpatient Program (IOP) and Substance Abuse Comprehensive Outpatient Treatment (SACOT) services is preferred, but not mandatory.

• Familiarity with behavioral health payer requirements, authorization procedures, and claims submission processes.

🏝️ Benefits

• Competitive salary.

• Health, dental, and vision insurance.

• Retirement savings plans.

• Professional development opportunities.

• A supportive work environment.