Medical Billing Specialist

Lifeline Medical Center

Northern (KY)

Hybrid

USD 42,000 - 66,000

Full time

11 hours ago

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Job summary

Lifeline Medical Center in Kentucky seeks an experienced Medical Billing Specialist to join our outpatient billing team. You will verify insurance coverage, manage claims, and ensure accurate coding for behavioral health and primary care services.

You will handle full-cycle billing, follow up on denials, post payments, and collaborate with providers and payers to resolve issues. The ideal candidate has 5+ years of experience, strong CPT/HCPCS/ICD-10-CM knowledge, and a commitment to accuracy.

Qualifications

5+ years of outpatient medical billing experience is REQUIRED.
Experience with mental/behavioral health and primary care billing.
Experience must include full-cycle billing.
Provide professional references that can verify billing experience and performance.
A billing knowledge assessment may be required during interview.
Experience with commercial insurance, Medicare, Medicaid, and managed care plans
Strong understanding of CPT, HCPCS, ICD-10-CM, modifiers, and payer billing requirements
Experience working denials, rejections, unpaid claims, and aging accounts
Experience with electronic claims, clearinghouses, payer portals, and EHR/practice management systems
Ability to independently research and resolve billing problems
Primary care (PCP) billing experience

Responsibilities

Verify patient insurance eligibility and benefits.
Confirm coverage and payer information prior to billing.
Verify coordination of benefits (COB).
Identify primary, secondary, and tertiary insurance.
Review patient demographics and insurance information for accuracy.
Review provider documentation for billing readiness.
Review CPT, HCPCS, ICD-10-CM, modifiers, units, place of service, and other claim information.
Identify missing or inconsistent billing information before claims are submitted.
Prepare and submit clean electronic and paper claims.
Submit primary and secondary claims.
Correct clearinghouse and payer claim rejections.
Monitor claim acceptance reports and track through adjudication.
Review EOBs and ERAs; post insurance payments and adjustments.
Post patient payments when assigned; review contractual adjustments.
Identify incorrect payments and underpayments; follow up on unpaid/ delayed claims.

Skills

Extremely dependable

Highly responsive

Detail-oriented and accurate

Organized and productive

Comfortable working independently

Able to prioritize a large workload

Able to research answers instead of

Persistent with insurance follow-up

Comfortable communicating directly

Able to recognize when something does

Willing to act immediately

Education

High school diploma or GED

Medical Billing and Coding certification

Job description

Lifeline Medical is a mission-driven medical and behavioral health organization dedicated to improving access to high-quality, compassionate health care. We provide evidence-based clinical services designed to support individuals across the full continuum of physical, emotional, psychological, and behavioral needs. Our team of licensed providers delivers care that is patient-centered, outcomes-focused, and grounded in clinical integrity. By combining modern care delivery models with a human-first approach, we create an environment where patients feel safe, supported, and empowered to achieve lasting stability and improved quality of life. At Lifeline Medical, we are committed to removing barriers to care, strengthening communities, and setting a higher standard for accessible and ethical mental healthcare.

Job Duties

Verify patient insurance eligibility and benefits
Confirm coverage and payer information prior to billing
Verify coordination of benefits (COB)
Identify primary, secondary, and tertiary insurance
Review patient demographics and insurance information for accuracy
Review provider documentation for billing readiness
Review CPT, HCPCS, ICD-10-CM, modifiers, units, place of service, and other claim information
Identify missing or inconsistent billing information before claims are submitted
Prepare and submit clean electronic and paper claims
Submit primary and secondary claims
Correct clearinghouse and payer claim rejections
Monitor claim acceptance reports
Track claims through adjudication
Review EOBs and ERAs
Post insurance payments and adjustments
Post patient payments when assigned
Review contractual adjustments
Identify incorrect payments and underpayments
Follow up on unpaid and delayed claims
Work insurance aging reports
Work accounts receivable (A/R) by payer and aging category
Research claims through payer portals and telephone follow-up
Correct and resubmit claims when appropriate
Prepare corrected and replacement claims
Identify and resolve timely-filing issues
Work denied claims from initial denial through resolution
Research denial reasons and determine appropriate corrective action
Prepare and submit reconsiderations and appeals
Follow up on submitted appeals
Obtain claim status and document all follow-up activity
Review authorization-related denials and billing issues
Identify credentialing or enrollment-related claim problems and elevate appropriately
Research payer policies and billing requirements
Work recoupments, take-backs, and overpayment notices as assigned
Assist with payer requests for records and billing information
Reconcile payments and identify missing ERAs/EOBs
Maintain accurate billing notes and account documentation
Communicate billing issues to providers, management, and other departments
Identify recurring billing problems and immediately bring them to management's attention
Assist with month-end billing and A/R reconciliation
Maintain organized follow-up lists and meet billing deadlines

Education

High school diploma or GED required.
Medical Billing and Coding certification

Qualification

5+ years of outpatient medical billing experience is REQUIRED.
Candidates must have both mental/behavioral health and primary care billing experience.
Experience must include full-cycle billing
Applicants should be prepared to provide professional references that can verify their billing experience and performance.
A billing knowledge assessment may be required during the interview process.
Experience working with commercial insurance, Medicare, Medicaid, and managed care plans
Strong understanding of CPT, HCPCS, ICD-10-CM, modifiers, and payer billing requirements
Experience working denials, rejections, unpaid claims, and aging accounts
Experience with electronic claims, clearinghouses, payer portals, and EHR/practice management systems
Ability to independently research and resolve billing problems
Primary care (PCP) billing experience

Skill

Extremely dependable
Highly responsive
Detail-oriented and accurate
Organized and productive
Comfortable working independently
Able to prioritize a large workload
Able to research answers instead of waiting to be told what to do
Persistent with insurance follow-up
Comfortable communicating directly with insurance companies
Able to recognize when something does not look correct
Willing to ... immediately

Mental Health Billing Experience

Applicants should have strong familiarity with outpatient behavioral health billing, including:

Psychiatric diagnostic evaluations
Psychiatric medication management
Psychotherapy
Psychotherapy provided with E/M services
Individual and family therapy
Behavioral health assessments
Screening services
Telehealth services
Mental health CPT and HCPCS codes
Behavioral health authorization requirements
Documentation and billing requirements associated with behavioral health services

Experience billing services provided by PMHNPs, psychiatrists, LPCs, LCSWs, psychologists, and other behavioral health professionals is strongly preferred.

Primary Care Billing Experience