Billing Specialist - IN PERSON

ADP; Cleveland (OH); On-site; USD 40,000 - 50,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Paid time off

Holidays

Job summary

Northern Ohio Recovery Association (NORA) is seeking a Billing Specialist to support revenue cycle operations in Cleveland. You will ensure accurate claims submission, eligibility checks, authorization management, and timely reimbursement across payer types.

The role requires Medicaid billing knowledge and experience with EMR and billing software. You will collaborate with clinical and administrative teams while maintaining HIPAA compliance and high professional standards.

Qualifications

• Minimum two years of experience in behavioral healthcare or revenue cycle.
• Behavioral health and/or substance use disorder experience required.
• Knowledge of Medicaid billing and insurance authorization processes.
• Ability to interpret clinical documentation and communicate information clearly.
• Proficiency with billing software and payer portals.
• Strong attention to detail and organization.

Responsibilities

• Submit and monitor claims accurately and timely; resolve discrepancies.
• Process accounts payable and complete billing reports.
• Verify Medicaid eligibility for outpatient clients.
• Manage payer authorizations across the continuum of care.
• Track authorization requirements, levels of care, units/days, dates, and numbers.
• Review clinical documentation and collaborate with treatment teams for medical necessity.
• Communicate clinical information to payer representatives per guidelines.
• Monitor authorization deadlines and escalate issues before reimbursement risks.
• Prepare case summaries and supporting docs for appeals and follow-ups.
• Review payer correspondence and uptake follow-up within deadlines.
• Participate in denial reviews, audits, and performance-improvement activities.
• Maintain knowledge of payer requirements and regulatory standards.
• Collaborate with Billing, Clinical, Compliance, and Revenue Cycle partners.
• Maintain accurate records in EMR, payer portals, and tracking systems.
• Protect client privacy and HIPAA compliance.
• Provide professional internal/external customer service.
• Maintain compliance with policies and procedures.
• Complete special projects as assigned.

Skills

Billing experience

Medicaid billing

Payer follow-up

HIPAA compliance

Attention to detail

Tools

Billing software

EMR system

Microsoft Office

Payer portals

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Full Time 55th Main Office, Cleveland, OH, US

3 days ago Requisition ID: 1013

Salary Range: $40,000.00 To $50,000.00 Annually

Organization: Northern Ohio Recovery Association (NORA)

The Billing Specialist supports NORA’s billing and revenue cycle operations by ensuring accurate

claims submission, authorization management, reimbursement monitoring, Medicaid eligibility,

accounts payable activities, and payer follow-up. The position works closely with clinical and

administrative teams to support timely reimbursement, accurate documentation, and

compliance with payer, regulatory, HIPAA, 42 CFR Part 2, and organizational requirements. This

position is expected to model professionalism, recovery principles, and prosocial behavior in all

interactions.

Key Responsibilities

• Submit and monitor claims accurately and timely; identify and resolve billing discrepancies and reimbursement issues.


• Process and monitor accounts payable activities and complete required billing documentation and reports.


• Verify Medicaid eligibility for outpatient clients and maintain accurate eligibility and billing records.


• Manage payer authorizations across the continuum of care, including admissions, precertification, concurrent and continued-stay reviews, step-downs, and retrospective reviews.


• Track authorization requirements, approved levels of care, units or days, effective and review dates, authorization numbers, and payer-specific conditions.


• Review clinical documentation and collaborate with treatment teams to obtain information needed to support medical necessity and authorization requests without directing clinical care or altering the clinical record.


• Communicate clinical information to payer representatives using applicable medical-necessity criteria and payer guidelines.


• Monitor authorization deadlines and assigned cases, escalating unresolved documentation, payer, or authorization issues before reimbursement is placed at risk.


• Identify documentation gaps, adverse determinations, and potential denials; coordinate peer-to-peer reviews, reconsideration's, appeals, and other payer escalation activities as assigned.


• Prepare case summaries and supporting documentation for appeals, peer reviews, audits, and payer follow-up.


• Review payer correspondence and adverse determinations, communicate outcomes to appropriate staff, and complete required follow-up within established deadlines.


• Participate in denial review, quality audits, root-cause analysis, training, and performance-improvement activities.


• Maintain working knowledge of payer requirements, authorization processes, medical-necessity criteria, and applicable regulatory standards.


• Collaborate with Billing, Clinical, Compliance, Patient Financial Services, Utilization Review, Admissions, and other Revenue Cycle partners.


• Maintain accurate records in the electronic medical record, payer portals, tracking systems, and other designated applications.


• Protect client privacy and maintain compliance with HIPAA, 42 CFR Part 2, payer requirements, accreditation standards, and NORA policies.


• Provide professional internal and external customer service and communicate effectively with clients, staff, payers, and regulatory entities.


• Maintain compliance with NORA’s Code of Ethics and Policies and Procedures Manual.


• Complete special projects and other duties as assigned.

Qualifications

• Minimum two years of experience in behavioral healthcare, substance use disorder treatment, revenue cycle, or a closely related field.


• Behavioral health and/or substance use disorder experience required.


• Working knowledge of Medicaid billing and insurance authorization processes.


• Knowledge of precertification, concurrent review, continued-stay review, authorization tracking, payer follow-up, and appeals.


• Ability to interpret clinical documentation and communicate information related to symptoms, functional impairment, risk, treatment needs, progress, and barriers to discharge.


• Knowledge of ASAM Criteria and experience with residential, inpatient, partial hospitalization, intensive outpatient, and outpatient levels of care preferred.


• Strong attention to detail, organization, documentation, and follow-through.


• Ability to manage multiple cases, deadlines, and competing priorities.


• Strong written, verbal, communication, and problem-solving skills.


• Proficiency with billing software, electronic medical records, Microsoft Office, and payer portals.


• Working knowledge of HIPAA and 42 CFR Part 2.


• Demonstrated commitment to confidentiality, professionalism, ethical conduct, and NORA’s mission.


• Competitive salary commensurate with experience.


• Health, dental, and vision insurance.


• Paid time off and holidays.

Amount of Travel

• Minimal, mostly confined to the Ohio Area.

Salary Range

• This is a paid position and salary will be rated based on experience