Billing Administrator - Mental Health Practice

& Consultation LLC; Washington (District of Columbia); Hybrid; USD 40,000 - 55,000; Full time

Job summary

CCCC LLC in Washington, DC is seeking a Billing Specialist to join our dedicated Billing Team. This role focuses on timely communication with clients, managing scheduling details, and handling insurance-related inquiries to support seamless service delivery.

The position emphasizes denial management, claims submission, eligibility checks, payment posting, and reconciliation to maintain a clean ledger and maximize accuracy in patient billing.

Responsibilities

• Denial management: review ERAs and EOBs for commercial and Medicare/Medicaid plans to identify and prioritize denials.
• Forensic appeals: draft and submit formal appeals for medical necessity or level of care denials with clinician support.
• A/R aging management: monitor 30, 60, 90+ day aging reports to resolve balances and reduce days in AR.
• Payer relations: contact insurance representatives to troubleshoot stuck claims and COB issues.
• Claim submission: submit claims for all payers electronically and on paper.
• Authorization recovery: obtain new and retroactive authorizations and monitor units used to prevent gaps for Medicaid.
• Eligibility verification: audit patient insurance status to catch lapses before sessions.
• Payment reconciliation: ensure insurance payments post correctly to keep ledger clean.
• Client payments: collect co-pays, deductibles, and other patient charges.
• Reporting: provide daily scheduling and online client payments reports.

Job description

Welcome to CCCC LLC, a flourishing Multi-Specialty Mental Healthcare Practice. For decades, we've been serving the communities of DC, MD, and VA with accessible and insurance-accepted behavioral healthcare solutions. Now, we're thrilled to offer you the chance to be a part of our growing success story.

Position Overview: Billing Specialist

We're excited to extend an invitation to talented individuals like you to join our skilled, hard-working, and goal-oriented Billing Team. This is a unique opportunity to make an impact as a key contributor at our Washington, DC. location. Embrace a fulfilling Monday-Friday schedule, 8:30am-5:00pm

What Sets Us Apart: Our Mission

At CCCC LLC, our mission is a driving force that unites us as a team. Together, we're committed to delivering high-quality, accessible, and culturally-sensitive mental health services, training, and consultation to those in need.

Your Responsibilities and Duties:

Client Communication

• Ensure seamless communication with clients regarding scheduling options, clinician details, services, and insurance-related queries.
• Uphold our commitment to timely communication by addressing emails, voicemails, and faxes within 24 hours.

Client Billing

• Denial Management: Perform daily reviews of ERAs and EOBs for commercial and Medicare/Medicaid plans to identify, categorize, and prioritize rejected and/or denied claims.
• Forensic Appeals: Draft and submit formal appeals for "medical necessity" or "level of care" denials, coordinating with clinicians for supporting documentation.
• A/R Aging Management: Systematically work 30, 60, and 90+ day aging reports to resolve outstanding balances and reduce "days in AR."
• Payer Relations: Contact insurance representatives directly to troubleshoot stuck claims and navigate complex "coordination of benefits" (COB) issues.
• Claim Submission: Submits claims for all payers electronic and paper.
• Authorization Recovery: Secure new and retroactive authorizations for services rendered and monitor current "units used" to prevent future gaps in coverage for Medicaid payers. Familiarized with insurance websites and authorization forms and faxes.
• Eligibility Verification: Conduct regular audits of patient insurance status to catch lapsed coverage before sessions occur.
• Payment Reconciliation: Ensure all insurance payments are accurately posted to maintain a "clean" and accurate ledger.
• Client Payments: Responsible for collecting client co-payments, deductibles, etc.
• Reporting: Daily reporting for scheduling and online client payments