Overview
This role supports the National Revenue Cycle Management (RCM) Strategy team by ensuring accurate and thorough review of claims submitted to payers and insurance companies for reimbursement. The position involves working closely with the Billing leadership team to facilitate timely and accurate processing of patient accounts. It requires strong self-accountability and the ability to work independently within a virtual team environment. This is a fully remote position open to candidates located anywhere within the United States.
Responsibilities
- Perform claim-level reviews after identifying national trends and root causes
- Maintain up-to-date knowledge of correct and lawful billing practices for payers
- Submit corrected claims to payers for reconsideration as needed
- Conduct posting reviews and resubmit claims to payers when necessary
- Verify patient demographic information related to insurance status and coordination of benefits (COB)
- Review Electronic Remittance Advices (ERAs) to understand charges, expected allowable amounts, and actual allowable amounts
Requirements
- High school diploma or GED equivalent
- Minimum 1 year of experience in a medical billing role
- At least 2 years of experience in Behavioral Health or Mental Health billing preferred
- Experience with electronic medical/health record systems, preferably AdvancedMD
- Understanding of Employee Assistance Programs (EAP) and Behavioral Health carve-out plans
- Knowledge of CPT codes, modifiers, mental health provider types, and their impact on reimbursement
- Familiarity with healthcare privacy legislation such as HIPAA
- Strong attention to detail
- Legal authorization to work in the United States
- Demonstrated cultural awareness and sensitivity, with experience working with diverse populations
Physical Requirements
- Ability to sit, stand, bend, talk, and hear regularly
- Frequent walking required
- Ability to lift and/or move objects up to 25 pounds
- Visual abilities including close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus
- Reasonable accommodations will be made for individuals with disabilities to perform essential functions
Compensation & Benefits
- Hourly pay range: $20.00 to $24.00, with potential for bonus
- Medical, dental, and vision insurance
- Accidental Death & Dismemberment (AD&D) insurance
- Short-term and long-term disability insurance
- Life insurance
- 401(k) retirement savings plan with employer match
- Paid parental leave
- Paid time off and holiday pay
- Employee Assistance Program (EAP)
Location
- Fully remote position
- Must be located within the United States