Billing Administrator - Mental Health Practice

Capitol-Hill-Consortium-For-Counseling-; Washington (District of Columbia); On-site; USD 48,000 - 62,000; Full time

Job summary

CCCC LLC in Washington, DC is seeking a Billing Specialist to join our clinical team and support a multi-state patient base. The role features a Monday–Friday schedule, 8:30am–5:00pm, focusing on accurate billing, denial management, and timely client communication.

As part of our Billing Team, you will handle insurance coordination, claim submissions, eligibility checks, and payment reconciliations while ensuring a high level of service and compliance with payer requirements.

Responsibilities

• Communicate with clients about scheduling options, clinician details, services, and insurance-related queries.
• Address emails, voicemails, and faxes within 24 hours to maintain timely communication.
• Review ERAs and EOBs for commercial and Medicare/Medicaid plans to identify, categorize, and prioritize denials.
• Draft and submit forensic appeals for medical necessity or level of care denials, coordinating with clinicians.
• Manage A/R aging by working 30, 60, and 90+ day reports to resolve balances.
• Contact insurance representatives to troubleshoot stuck claims and COB issues.
• Submit claims for all payers electronically and on paper.
• Secure new and retroactive authorizations and monitor units used to prevent gaps in coverage.
• Regularly audit patient insurance status to catch lapses before sessions.
• Ensure insurance payments are posted accurately to keep the ledger clean.
• Collect client co-pays and other payments.
• Provide daily reporting for scheduling and online client payments.

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