Remote Billing Specialist

Review claims for accuracy and completeness prior to submission, including patient demographics, insurance information, provider information, coding, modifiers, place of service, and other billing requirements.

Submit clean claims to commercial insurance, Medicare, Medicaid, and managed care payors.

Monitor claim status and proactively follow up on unpaid, underpaid, rejected, and denied claims.

Research and resolve claim denials and rejections, including identifying root causes, making necessary corrections, submitting reconsiderations or appeals, and tracking claims through resolution.

Work accounts receivable and aging reports according to established follow-up timelines and priorities.

Review payor remittances and Explanation of Benefits/Explanation of Payment documentation to identify payment discrepancies, denials, recoupments, and other issues requiring follow-up.

Identify underpayments and reimbursement discrepancies and escalate or pursue resolution as appropriate.

Correct and resubmit claims when billing errors or payor requirements are identified.

Communicate with insurance companies regarding eligibility, claim status, authorization, reimbursement, and other billing-related issues.

Maintain clear and complete documentation of billing follow-up and actions taken.

Identify recurring denial patterns, payor issues, or workflow problems and communicate trends to Revenue Cycle leadership.

Collaborate with clinical, operations, credentialing, and revenue cycle teams to resolve issues affecting claim submission or reimbursement.

Maintain working knowledge of payor billing requirements and changes impacting reimbursement.

Support billing-related audits, reconciliations, and other revenue cycle initiatives as needed.

Timely and accurate submission of clean claims.

Effective follow-up and resolution of outstanding accounts receivable.

Reduction and timely resolution of claim denials and rejections.

Accurate identification and recovery of underpayments.

Thorough and consistent documentation of billing activity.

Ability to independently research and resolve payor and claim issues.

Identification of recurring billing trends and opportunities to improve revenue cycle processes.

Minimum of 5 years of hands-on medical billing and accounts receivable experience.

Strong experience working claims across the full billing lifecycle, from initial submission through final payment or resolution.

Experience billing commercial insurance, Medicare, and Medicaid.

Strong knowledge of claim submission, rejection resolution, denial management, appeals, accounts receivable follow-up, and payor reimbursement.

Working knowledge of CPT, HCPCS, ICD-10-CM, modifiers, place-of-service requirements, and standard healthcare billing terminology.

Experience using payor portals, clearinghouses, and electronic health record/practice management systems.

Demonstrated ability to research complex billing issues and independently determine appropriate next steps.

Strong attention to detail and ability to identify inconsistencies or errors that may impact reimbursement.

Ability to prioritize a high-volume workload and consistently follow claims through resolution.

Strong written and verbal communication skills.

Comfort working independently in a remote, fast-moving environment.

An openness to and ability to respond to constructive feedback.

A desire to improve mental health care delivery.

Medical billing experience within behavioral health, psychiatry, or mental health services strongly preferred.

Experience billing psychotherapy, psychiatric evaluation, crisis services, and evaluation and management services.

Experience working within a multi-state healthcare or telehealth organization.

Experience with both fee-for-service Medicaid and Medicaid managed care.

Experience identifying denial trends and contributing to process improvements that improve clean claim rates and reimbursement.

CPC, CPB, or other relevant billing/coding certification is a plus, but not required with equivalent hands-on experience.

Previous experience working remotely.

Be a cultural carrier who embodies our values:

Safety above all else. We operate in a space with life and death repercussions, and every member of our team takes that responsibility seriously. We all look for and call out patient safety concerns.

Maximize measurable impact. We put our patients first. We are tenacious about doing good, and we have the outcomes to prove it. Our work is guided by measurable hypotheses that we test and re-evaluate. 

Build inclusively and equitably. We are committed to decreasing the systemic inequalities in healthcare and to building an organization where a diverse group of patients and employees can thrive. We seek to understand and learn from differences rather than minimize them. 

Stakes determine speed. Where the stakes are low, we optimize for quick learnings and progress. Where the stakes are higher, we are more thoughtful and methodical. Where safety is a concern, we optimize for zero errors. 

Constellations, not stars. We believe a well functioning team is worth much more than a collection of individuals, and we invest in bringing out the best in each other. We are kind, loyal, and direct.

Honor commitments; honor yourself. We do our best work when we are fulfilled, our core needs are met, and there is joy along the way. We are clear about what we can and can’t do so that we can honor our commitments and fulfill them excellently. 

Empowerment and empathy. Wherever possible, we empower others rather than decide for them. When we make decisions that affect others, we seek their perspective and minimize harm done.

PTO includes sick leave, certain federal holidays, and vacation 

Wellness and Internet stipend 

401K 

Medical, dental and vision insurance