Medical Billing Specialist (Behavioral Health)

Job Description

Job Description

Description :

At Medusind we take immense pride in offering superior, cost-effective solutions covering the whole spectrum of tasks and processes to the healthcare industry.

A significant factor is that our workforce comes with a rich domain expertise and robust compliance norms.

Our four-prong approach of an excellent management team coupled with detailed eye for processes, experienced manpower, and cutting-edge technology helps us deliver superior, cost-effective services to our clients across the globe.

Benefits :

• Health insurance.
• Dental insurance.
• Vision insurance.
• Employer paid life insurance.
• Employer paid short-term and long-term disability.
• Voluntary additional life insurance.
• Employee Assistance Program.
• 48 hours of sick time after three months.
• 80 hours of vacation time after six months.
• $400 referral bonuses.

Duties include but are not limited to :

• Auditing and Compliance Analysis
• Conduct detailed audits on claims and billing submissions to ensure accuracy, completeness, and compliance with payer-specific guidelines, including Medicare and Medicaid regulations.
• Identify trends in claim denials and recommend corrective actions to improve billing processes and compliance.
• Claims Submission
• Prepare and submit claims for behavioral health services, ensuring they meet all payer requirements for accuracy and timeliness.
• Track and analyze claims submission outcomes, identifying patterns in denials and rejections, and developing strategies to mitigate issues for assigned accounts.
• Maintain regular follow-up on claim submission, ensuring prompt resolution of incomplete, not on file or rejected claims.
• Billing and Charge Review
• Review and analyze charges for behavioral health services to verify they align with payer policies, applicable coding standards, and the specifics of patient coverage.
• Validate patient eligibility, benefits, and authorization information provided by team members to proactively prevent claim rejections and ensure timely reimbursement.
• Reconcile billing discrepancies by researching charge inconsistencies, payments, and adjustments to ensure accurate financial records.
• Team Collaboration and Resource Support
• Act as a resource for the internal teams, providing insight into billing policies and statuses, compliance requirements, and efficient use of billing software systems.
• Train and support team members on best practices in auditing, claims submission, and payer regulations to foster knowledge-sharing and process improvement.
• Collaborate with clinical and administrative staff to ensure billing accuracy and documentation compliance, identifying any gaps or improvements needed in processes.

Requirements :

• Education : High school diploma or equivalent required; Associate degree or certification in medical billing / coding preferred.
• Experience :
• Minimum of 3-5 years of experience in medical billing, with a focus on behavioral health services preferred.
• Demonstrated proficiency with Medicare, Medicaid, and commercial insurance billing, particularly in auditing and claims analysis.
• Skills :
• Strong expertise in billing software and electronic billing systems.
• Analytical mindset with exceptional attention to detail, problem-solving, and organizational skills.
• Effective communication skills, with the ability to clearly convey complex billing issues and analysis findings.
• Ability to work independently, prioritize tasks, and act as a collaborative team member.
3 days ago