Medical Billing Specialist – Psychiatric RCM

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

📋 Description

• Manage all internal billing and collection processes for a psychiatric and mental health practice from start to finish.

• Assess claims for precision and identify any billing discrepancies prior to submission.

• Submit claims, handle claim rejections and denials, and file corrected claims and appeals as necessary.

• Investigate and resolve issues related to underpayments and discrepancies with payers.

• Review accounts receivable aging reports to guarantee timely reimbursements.

• Act as the primary point of contact between the practice and external billing vendors.

• Oversee patient balances and collection efforts.

• Reach out to patients regarding outstanding balances and establish payment plans when suitable.

• Process patient payments and maintain precise account balances.

• Reconcile discrepancies in payments and investigate billing issues.

• Keep financial documentation and patient account records up to date.

• Serve as the main contact for the practice's billing helpline.

• Address patient inquiries regarding deductibles, copayments, coinsurance, eligibility, benefits, balances, payment plans, and billing statements.

• Provide billing statements, itemized receipts, and payment histories upon request.

• Clearly, professionally, and compassionately explain billing information.

• Resolve patient billing issues and escalate complex cases when necessary.

• Monitor and report on revenue cycle metrics, including days in AR, AR aging, clean claim rates, claim submission delays, payment posting timeliness, and patient collection effectiveness.

• Prepare billing reports using Excel and other reporting tools.

• Proactively identify performance trends and issues to discuss with the practice manager.

• Ensure compliance with HIPAA regulations, payer guidelines, and relevant federal and state laws.

• Verify that billing documentation supports medical necessity and payer requirements.

• Collaborate with administrative staff and leadership to address billing concerns and enhance operational processes.

• Complete the application process, including prequalifying questions, a video introduction, role-specific assessment (if applicable), recruitment interview, executive interview, client interview, and background/reference check.

⛳️ Requirements

• Minimum of 2 to 3 years of demonstrated experience in full-cycle medical billing and revenue cycle management, with recent experience in psychiatric or behavioral health billing required.

• Proficiency in eClinicalWorks (eCW) with recent practical experience; eCW proficiency is a mandatory requirement.

• Proven experience in Medicare billing practices.

• HIPAA certification along with a strong understanding of HIPAA compliance requirements.

• Comprehensive knowledge of the complete medical billing lifecycle, including claims management, payment posting, denials, collections, and accounts receivable.

• Experience with commercial insurance plans, Medicaid, and managed care organizations, in addition to Medicare.

• Strong understanding of CPT coding, ICD-10 coding, insurance terminology, and payer guidelines specific to a psychiatric practice.

• Excellent phone etiquette and communication skills to discuss financial matters with patients in a professional and compassionate manner.

• Strong reporting capabilities with proficiency in Excel and other reporting tools.

• Highly organized, detail-oriented, and capable of managing multiple priorities independently in a fast-paced environment.

• No prior commitments that would conflict with full-time employment.

• Reliable technical setup for remote work.

• Availability during US business hours.

• Updated resume required.

• A brief 1 to 2-minute Loom video introducing yourself, detailing your psychiatric billing and eCW experience, and explaining your approach to handling a denied claim is necessary.

• Only candidates who submit a Loom video will progress to the next stage of the hiring process.

🏝️ Benefits

• Paid Time Off in accordance with company policy.

• Observance of holidays as per company guidelines.

• 100% remote work setup.

• Compensation in USD, paid bi-monthly (on the 15th and 30th).

• Opportunity to work within a growing psychiatric and mental health practice with a dedicated, patient-focused team.

• High-ownership billing role with direct accountability for revenue cycle performance and the patient financial experience.