Medical Billing and A/R Follow-Up Specialist – Behavioral

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

📋 Description

• Confirm eligibility, benefits, and coordination of benefits, and verify authorization requirements for intensive outpatient and inpatient services.

• Prepare and submit professional claims, ensuring the accurate place of service, provider, facility, and date of service.

• Address clearinghouse rejections and front-end edits daily, making corrections and resubmitting claims the same day whenever possible.

• Follow up on unpaid claims through payer portals and phone calls, prioritizing aged claims and those at risk of missing deadlines.

• Manage denials using remittance advice and denial codes, correcting claims and filing timely appeals and reconsiderations.

• Monitor timely filing and appeal deadlines by payer to ensure that no claim exceeds filing limits.

• Post and reconcile payments from ERAs and EOBs, flagging underpayments against fee schedules for review.

• Report recurring denial trends by payer, provider, and reason code to the practice’s billing leadership.

• Document all actions clearly in the billing system.

• Safeguard patient information and adhere to HIPAA regulations.

⛳️ Requirements

• A minimum of 2 years of experience in U.S. healthcare insurance billing and accounts receivable follow-up.

• Practical experience with claim submission, denial management, and appeals, including the ability to interpret denial and remark codes.

• Knowledge of commercial insurance and government health plans, such as Medicare, Medicaid, managed Medicaid, and Medicare Advantage.

• Experience utilizing payer portals and insurance websites.

• Understanding of electronic claims and remittance processes (837/835, ERA/EOB).

• Basic proficiency in Excel for tracking accounts receivable and denials.

• Strong verbal and written English communication skills.

• Exceptional attention to detail and strong follow-up capabilities.

• Ability to work independently and efficiently manage a large volume of claims across various payers.

• Reliable internet access and a suitable remote work environment.

• Familiarity with Illinois Medicaid/Medicare and its managed care programs.

• Experience in supporting psychiatry or behavioral health practices.

• Knowledge of psychiatric CPT codes, including hospital care, nursing facility visits, psychiatric diagnostic evaluations, psychotherapy add-on codes, and outpatient E/M.

• Experience in billing across various care settings, such as inpatient, skilled nursing, intensive outpatient, and outpatient.

🏝️ Benefits

• Remote position.

• Full-time employment.

• Availability required during U.S. Central Time business hours.