Billing Specialist at Verisk overseeing invoicing processes and customer interactions. Collaborating across departments to ensure accurate billing and compliance in a hybrid working environment.
About the role
- Billing Specialist managing claims for substance abuse treatment operations at All In Solutions. Focus on timely billing, payment posting, and claim resolution across multiple states.
Responsibilities
- Prepare, audit, and submit timely and accurate electronic and paper claims to commercial payers, Medicaid, and Medicare across multiple states (NJ, FL, CA) for all levels of care (Detox, Residential, PHP, IOP).
- Accurately post electronic remittances (ERAs) and manual payments, reconciling them to patient accounts and preparing daily deposit reports.
- Research and resolve denied claims by identifying the root cause (e.g., authorization, coding, or documentation issues).
- Prepare and submit clear, complete documentation for claims reconsideration or appeal processes.
- Proactively manage and work aging A/R by contacting payers, resolving outstanding balances, and documenting all follow-up actions efficiently.
- Apply correct CPT, HCPCS, and ICD-10 codes for behavioral health and SUD services to ensure clean claim submission and regulatory compliance.
- Serve as a direct point of contact for payers to resolve claim rejections, verify benefit details, and confirm authorization requirements.
- Maintain meticulous records of all billing activities, communications, and remittance advice to ensure readiness for HIPAA and payer audits.
Requirements
- Bachelor’s degree in Healthcare Administration, Finance, Business, or related field strongly preferred (or equivalent experience).
- Minimum of 2 years of professional experience in a hands-on Medical Biller, Collections Specialist, or Revenue Cycle Specialist role, preferably within a behavioral health or SUD setting.
- Proven experience with CРT, HCPCS, and ICD-10 coding specific to psychiatric and substance use disorder services.
- Direct working proficiency with a major EMR and billing software system.
- Experience with Kipu EMR and/or Collaborate MD is highly desirable.
- Strong understanding of Explanation of Benefits (EOBs) and the ability to interpret payer contracts and fee schedules.
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