Billing Specialist

Department: Billing Employment Status: Full-Time Reports To: Chief Operations Officer Position Summary The Behavioral Health Billing Specialist is responsible for accurately processing and monitoring claims for behavioral health services. This position works closely with clinical staff, insurance companies, clients, and other departments to ensure services are properly documented, billed, and reimbursed. The Behavioral Health Billing Specialist must demonstrate attention to detail, confidentiality, professionalism, and knowledge of healthcare billing requirements. This position supports the financial operations of Lewis & Clark Behavioral Health Services while helping ensure clients receive accurate and timely information regarding their insurance coverage and accounts. Essential Duties and Responsibilities Submit claims to Medicaid, Medicare, commercial insurance companies, and other funding sources.Verify client insurance eligibility, coverage, benefits, authorizations, and service limitations.Ensure claims include the correct client information, provider, program, service location, diagnosis code, CPT code, modifier, and units of service.Enter and maintain accurate billing information in the electronic health record and billing systems.Review rejected and denied claims, identify the cause, make necessary corrections, and resubmit claims promptly.Monitor unpaid claims and follow up with insurance companies regarding outstanding balances.Complete timely follow-up on accounts receivable and document all collection efforts.Review explanation of benefits and electronic remittance advice for correct payment and adjustment information.Post insurance payments, adjustments, denials, and client payments accurately.Identify recurring billing problems and report trends to the appropriate supervisor.Communicate with clinical staff regarding missing, incomplete, or inconsistent documentation.Communicate professionally with clients regarding insurance coverage, statements, balances, and payment questions.Maintain accurate and organized billing records.Prepare billing, denial, accounts receivable, and productivity reports as requested.Assist with audits and quality-assurance reviews.Follow established billing procedures, payer requirements, organizational policies, and applicable state and federal regulations.Maintain the confidentiality of client and organizational information in accordance with HIPAA and other privacy requirements.Stay informed of changes to insurance requirements, billing regulations, and organizational procedures.Meet established deadlines and productivity expectations.Participate in departmental meetings, training, and process-improvement activities.Provide billing coverage and assistance to other team members as needed. Perform other duties as assigned.