Medical Billing Specialist

Top Job

Located in Kennewick, WA

Salary: $22+ DOE

Our client, a dedicated mental health practice, is hiring a skilled Medical Billing Specialist to manage the full revenue cycle, specializing in behavioral health services. This is a crucial role for ensuring financial health and compliance while supporting access to care.

Key Responsibilities

1. Insurance Billing and Mental Health Revenue Cycle

• Claim Submission: Prepare, review, and electronically submit professional claims (e.g., CPT codes 90832, 90837, 90847) to various commercial insurance carriers, Medicare, and EAPs (Employee Assistance Programs).
• Benefit Verification: Conduct thorough verification of client eligibility and benefits, paying close attention to deductibles, co-pays, coinsurance, and specific limits for mental health and behavioral services.
• A/R Follow-up: Proactively manage the accounts receivable by tracking outstanding claims, appealing denials, and resolving complex coding or documentation issues related to mental health services.
• Payment Posting: Accurately post insurance and patient payments (EOBs/ERAs) to client ledgers, ensuring correct application of contractual adjustments.
• Denial Analysis: Identify and address common denial reasons specific to mental health (e.g., medical necessity, prior authorization requirements, billing frequency) and implement preventative measures.

2. Compliance and Patient Financial Services

• Coding Accuracy: Ensure all services are billed using appropriate CPT, ICD-10 (specifically F-codes), and modifier codes, adhering strictly to current coding guidelines for counseling and therapy.
• Mental Health Parity: Maintain up-to-date knowledge of the Mental Health Parity and Addiction Equity Act (MHPAEA) and advocate for appropriate reimbursement consistent with parity regulations.
• Patient Billing: Manage private pay and sliding scale fees. Process client payments, generate monthly patient statements, and handle sensitive billing inquiries with empathy and professionalism.
• Confidentiality: Maintain absolute compliance with HIPAA and all state/federal confidentiality requirements, especially concerning sensitive mental health records.

3. Practice Support: Audits and Credentialing

• Audit Support: Assist the practice manager during internal or external insurance audits related to counseling claims. This includes compiling documentation, verifying session notes, and providing financial ledgers.
• Provider Credentialing: Provide active support for initial and ongoing provider credentialing and contracting with key insurance panels. This involves gathering required professional documents (licenses, NPI, DEA, CAQH), completing applications, and diligent follow-up until enrollment is complete.
• Process Documentation: Maintain comprehensive and organized records of all billing processes, payer communications, and credentialing status updates.

Qualifications

• Experience: Minimum of 2 years of experience in medical billing, with direct experience billing for mental/behavioral health services (e.g., LCSW, LMFT, LPC, Psychologist).
• Knowledge: Deep familiarity with mental health CPT and ICD-10 (F-code) coding. Strong working knowledge of commercial payers and Medicaid/Medicare billing rules.
• Skills: Proficiency with mental health-specific EMR/EHR systems (e.g., SimplePractice, TheraNest) and clearinghouses. Exceptional organizational and communication skills.
• Certification: Certified Professional Biller (CPB) or similar certification is strongly preferred.

Pay: $22+ DOE

About us:

Express works with job seekers to help find the right job for their skills and experience. As one of the leading staffing companies in North America, Washington, and Kennewick, we're ready to help you take the next step in your career. Whether you are ready for a full-time position, looking for part-time work, or want a more flexible schedule, Express has a wide range of jobs available including:

• Administrative
• Light Industrial
• Skilled Trades
• Professional positions

Our location:

7014 W Okanogan Pl.

Kennewick, WA 99336

#2907OS

Express Office: Kennewick

7014 Okanogan Place

Kennewick, WA 99336