Medical Billing Specialist: SoonerCare & Behavioral Health

KidsChoice Therapy and Play Center; Oklahoma City (OK); Sur place; USD 28 000 - 34 000; Plein temps

Résumé du poste

Mirarbelle Care is seeking a Billing Specialist / Billing Assistant at their Corporate Headquarters in Oklahoma City. The role focuses on accurate claim submission to SoonerCare and payers, posting payments, denial management, and accounts receivable within HIPAA-compliant processes.

Responsibilities include verifying codes and documentation, appealing denials, and ensuring up-to-date knowledge of Medicaid and other payer requirements.

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.
• Strong attention to detail and ability to identify billing discrepancies.
• Clearance of all required background checks and OIG/SAM.gov exclusion screen.

Responsabilités

• Submit claims to SoonerCare and commercial payers accurately and on a timely basis based on completed, locked session documentation in the Rethink EMR
• Verify that procedure codes, service dates, place of service, provider credentials, and authorization numbers on each claim match the corresponding clinical documentation exactly before submission
• 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 - do not submit a claim for a service that is not fully documented
• 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 Mirarbelle Care recordkeeping requirements

Connaissances

Medical billing

CPT/ICD-10 coding

HIPAA compliance

AR aging

Insurance verification

Attention to detail

SOONERCARE billing

Formation

High school diploma

Associate's degree or higher

Outils

Rethink EMR

Description du poste

Mirarbelle Care is seeking a Billing Specialist / Billing Assistant at their Corporate Headquarters in Oklahoma City. The role focuses on accurate claim submission to SoonerCare and payers, posting payments, denial management, and accounts receivable within HIPAA-compliant processes.

Responsibilities include verifying codes and documentation, appealing denials, and ensuring up-to-date knowledge of Medicaid and other payer requirements.