Remote AR Denial & Appeals Specialist - Behavioral Health Billing

Behavioral Health Network, Inc (BHN); Springfield (MA); Remoto; USD 32.000 - 37.000; Tempo pieno

Vantaggi offerti da questo lavoro

Generous PTO

403(b)

Educational assistance

Medical

Dental

Vision

Employee assistance programs

Descrizione del lavoro

Behavioral Health Network, Inc (BHN) is seeking a skilled Medical Billing Specialist to support AR follow-up, appeals, and BH codes in a remote role within the Eastern Time zone.

You will follow up on assigned claims at set intervals, review denials, navigate payer portals, and collaborate with the EHR Matrix team. The position requires 5 years in medical billing and HIPAA knowledge, with a strong analytic mindset and attention to accuracy. Remote 8am-4pm ET.

Competenze

• High School Diploma or GED required.
• Minimum of 5 years of experience in a medical billing department with strong AR account follow-up, appeals, and Behavioral Health codes and modifier knowledge required.
• Demonstrated knowledge of and experience in healthcare medical billing, claims processing, follow-up, and appeals required.
• Carelogic EHR with working knowledge and experience is a strong preference but not required.
• Must be a critical thinker with strong research, analytical, and mathematical skills.
• Current knowledge of HIPAA compliance, 42 CFR requirements, and changing regulatory guidelines.
• Extensive comprehension in utilizing email, search engines, and the Internet with the ability to effectively use payer websites.

Mansioni

• Follows up on all assigned claims (at 45 days, 60 days, and 90 days) to ensure timely reimbursement and bring claims to closure.
• Reviews denied claims for accuracy to ensure coding, billing rates, and modifiers are accurate before sending appeals or reconsiderations to payers.
• Investigates claims with no payer response to ensure the payer received the claim.
• Navigates payer websites and appeal processes as defined by all payers including Mass Health, Tricare, Medicare, Medicaid, and Medicare Advantage plans.
• Reviews and finds trends or patterns of denials to prevent errors.
• Assists and confers with the EHR Matrix team and Billing Manager concerning any coding or modifier setup issues.
• Responsible for identifying missing payments, overpayments, and analyzing credits on accounts. Initiates refund requests for credit and overpayments.

Conoscenze

AR account follow-up

Appeals

Behavioral Health codes

Modifier knowledge

HIPAA knowledge

Carelogic EHR

Analytical skills

Research skills

Formazione

High School Diploma or GED

Strumenti

Carelogic EHR

Descrizione del lavoro

Behavioral Health Network, Inc (BHN) is seeking a skilled Medical Billing Specialist to support AR follow-up, appeals, and BH codes in a remote role within the Eastern Time zone.

You will follow up on assigned claims at set intervals, review denials, navigate payer portals, and collaborate with the EHR Matrix team. The position requires 5 years in medical billing and HIPAA knowledge, with a strong analytic mindset and attention to accuracy. Remote 8am-4pm ET.