Billing Specialist

Judson Center; Farmington Hills (MI); On-site; USD 45,000 - 65,000; Full time

Job summary

Judson Center is seeking a Billing Specialist to ensure accurate billing to Medicaid/Medicare, commercial insurers, and other sources. You will work with program staff and finance to post payments, verify CPT codes, and maintain timely AR. Knowledge of 837 billing and behavior health billing is a plus.

The role emphasizes posting within 48 hours of deposits, auditing support, and consistent denial follow-up, with occasional non-traditional hours.

Qualifications

• High school diploma required; associates/bachelor’s preferred.
• Five years of medical billing experience required.
• Billing/coding certification preferred; behavioral health billing knowledge is a plus.

Responsibilities

• Compile and process billing for services rendered within 24 hours.
• Review CPT coding accuracy in compliance with payer rules.
• Follow up on unpaid claims; denials reviewed/rebilled within 14 days.
• Post revenue into the EHR within 48 hours of bank deposit.
• Assist Finance with audits and reconcile AR/GL discrepancies.
• Monitor timely filing and provide clerical support when needed.

Skills

Medical billing experience

Excel

Word

EHR systems

837 billing knowledge

Attention to detail

Education

High school diploma

Associates or Bachelor's preferred

Billing/coding certification preferred

Tools

Netsmart EHR

Eclinical Works

Microsoft Office

Job description

The primary responsibility of the Billing Specialist is to support the accurate billing and payment posting to all payers following all applicable guidelines. Conduct accurate and timely billing to the appropriate parties, including but not limited to Medicaid/Medicare, Commercial insurances, private pay consumers and other funding sources. The Billing Specialist works closely with program staff and leadership as well as with the accounting departments of all contracting and/or referring sources to ensure payment is obtained for all services rendered. The Billing Specialist must have a thorough understanding of the services being delivered and corresponding CPT billing codes and must process all billing in full compliance with the Deficit Reduction Act and the Medicare-Medicaid Anti-Fraud and Abuse Amendments.

Primary Duties and Responsibilities

• Compiles and processes billing for services rendered through electronic systems and claims will be processed within 24 hours of creation.
• Reviewing claims for accuracy of CPT Coding in compliance with payer rules.
• Follow up with insurance payers regarding unpaid claims, takebacks or denials. Denials will not exceed 2% of total claims billed per week. All Denied claims must be reviewed, written off, or rebilled within 14 days.
• Works with program staff to resolve authorization or documentation related issues.
• Documents, reconciles, and posts revenue into electronic health record daily (the posting should occur within 48 hours of bank deposit.)
• Works with the Finance Department to assist with audits, resolve discrepancies and reconcile balances between AR and GL.
• Ensures promptness of review and response as well as monitoring for timely filing with all payers
• Maintains Accounts Receivable within 60-day timeframe. Explanations should be noted for any claims exceeding 60 days in AR.
• Provides general clerical support (answering phones, filing, etc.) when needed.
• Verifies insurance coverage, as needed.
• Completes three (3) hours of educational training related to billing annually. (Webinars or through professional associations)
• Completes any and all other duties as assigned by supervisor.

Qualifications

• High school diploma required; associates or bachelor’s degree preferred.
• Certification in billing/coding preferred
• Medical billing experience at a comparable behavioral health or health and human services agency.
• Strong computer skills including experience in EHR System, Patient Management system, spreadsheets, and other analytical tools, systems conversion experience a plus; Proficiency in use of Microsoft Office with advanced Excel skills.

Skills Required

• Five years of medical billing experience required.
• Computer literate with strong skills in Excel and Word. Database experience a plus.
• Ability to work with minimal supervision
• Knowledge of EHR systems (ex. Netsmart, Eclinical).
• Familiarity with 837 billing and importing of files.
• Familiar with behavioral health billing, including the ability to accurately complete fee agreements, HCFAs, interpret EOBs and negotiate accordingly, when applicable
• Problem solving skills, especially with software issues related to billing processes
• Excellent math and written/verbal communication skills
• Ability to provide culturally competent services that shows sensitivity to the service population’s cultural and socioeconomic characteristics.

Working Conditions

• Generally, an office environment with a cubicle/office or reception area workstation.
• Ability to travel and attend meetings at various locations may be required.
• Some non-traditional hours such as evenings or weekends may be required.

This description is intended to describe the type and level of work being performed by a person assigned to this job. It is not an exhaustive list of all duties and responsibilities of a person so classified. The employee is expected to adhere to all company policies and perform other duties as assigned for the good of the consumers, the program, the department, and the agency.