Healthcare Billing Specialist — Claims & AR Expert

Mirabelle Care; Oklahoma City (OK); On-site; USD 42,000 - 56,000; Full time

Job summary

Mirarbelle Care is seeking a Billing Specialist to manage accurate claim submissions to SoonerCare and other payers, ensuring proper documentation and timely revenue collection. The role requires attention to detail, knowledge of CPT/ICD-10 coding, and experience with EMR systems such as Rethink EMR.

The ideal candidate will handle post-payments, denials, and appeals, while verifying insurance eligibility and maintaining HIPAA-compliant records.

Qualifications

• High school diploma required; associate's degree or higher preferred.
• Minimum 1 year of medical billing experience; SoonerCare/Oklahoma Medicaid billing experience preferred.
• Knowledge of CPT/ICD-10 coding and insurance verification.
• Experience with ABA, SLP, OT, or behavioral health billing preferred.
• Proficiency with billing and EMR systems; Rethink EMR experience a plus.
• Clearance of all required background checks and OIG/SAM.gov exclusion screen.

Responsibilities

• Submit claims to SoonerCare and commercial payers accurately and timely.
• Verify procedure codes, service dates, place of service, provider credentials, and authorization numbers on each claim.
• Post payments, adjustments, and denials to patient accounts accurately and within required timelines.
• Follow up on unpaid, underpaid, and denied claims within established AR follow-up timelines.
• Prepare and submit claim appeals with supporting clinical documentation as directed by the Billing Director.
• Flag documentation deficiencies, billing discrepancies, or mismatches between documentation and billing to the Billing Director and Compliance Officer immediately.
• Verify insurance eligibility and benefits for assigned accounts as needed.
• Generate and review AR aging reports; identify and escalate problem accounts to the Billing Director.
• Maintain current knowledge of SoonerCare billing requirements, CPT/ICD-10 codes, and procedure code updates for ABA, SLP, OT, and Counseling.
• Maintain accurate billing records and documentation in compliance with HIPAA and Mir arbelle Care recordkeeping requirements.

Skills

Medical billing

Accounts receivable

Insurance verification

CPT/ICD-10 coding

AR follow-up

Attention to detail

HIPAA compliance

Behavioral health billing

Education

High school diploma

Associate's degree or higher preferred

Tools

Rethink EMR

Job description

Mirarbelle Care is seeking a Billing Specialist to manage accurate claim submissions to SoonerCare and other payers, ensuring proper documentation and timely revenue collection. The role requires attention to detail, knowledge of CPT/ICD-10 coding, and experience with EMR systems such as Rethink EMR.

The ideal candidate will handle post-payments, denials, and appeals, while verifying insurance eligibility and maintaining HIPAA-compliant records.