Medical Biller

Job Description

Job Description

For over 15 years, The Dorm has been a mission-driven, client-centered mental health organization that has been bringing comprehensive, evidence-based treatment to young adults, ages 18-30.

We are looking for a passionate Medical Biller to join our multidisciplinary team and contribute to our goal of making a difference.

With us, you’ll be part of the next frontier in mental health care with an integrative treatment model and outcomes research approved by a third-party validated Institutional Review Board (IRB).

We blend individualized therapy and skills coaching, hands-on family work, group-based clinical support and a bustling community and social Clubhouse experience unseen elsewhere in our industry.

With competitive salaries between $60,000 and $75,000 (based on background / experience) and a proud commitment to diversity in the workplace that affirms all races, genders and backgrounds, our strength is our community and we hope that includes you!

What You Will Do :

• Prepare complete, accurate and timely claims and batch to insurance carriers for reimbursement.
• Investigate claim denials timely, identify reasons for denials, and take appropriate actions to appeal or correct denied claims to ensure maximum reimbursement.
• Speak to prospective families around their out-of-network benefits and possible reimbursements for treatment.
• Help families verify coverage and eligibility including obtaining pre-authorization for treatment, as needed.
• Provide ongoing customer service and support for clients and families to understand their reimbursement, assist with questions and facilitate any further inquiries with the carrier.
• Ensure compliance with relevant healthcare regulations, coding guidelines, insurance policies, and follow best practices for medical billing and coding.
• Monitor outstanding claims, conduct follow-up with insurance companies, and address denials or discrepancies to facilitate timely reimbursement.
• Record and reconcile payments received, ensuring accuracy, and update patient accounts accordingly.
• Generate and analyze financial reports related to billing, collections, and outstanding accounts, providing insights to management.
• Investigate and analyze claim denials, identifying root causes and implementing corrective actions to ensure successful claim resubmission and reimbursement.
• Collaborate with internal and external auditors to prepare for insurance audits, providing the necessary documentation and ensuring compliance with regulatory requirements.
• Facilitate partnership with insurance carriers to ensure all billing activities are compliant with their policies.
• Maintain positive, collaborative and respectful relationships with all current clients, prospective clients, staff, and referral sources.

What You Need to Qualify :

• A minimum of 2-3 years of experience in medical billing, preferably in an outpatient behavioral health setting.
• Organized, detail-oriented thinker who is self-motivated and seeks to see projects till successful completion.
• Dedicated to providing outstanding customer service, striving to foster an exceptional experience to both clients and staff.
• Strong written and verbal communication and strong interpersonal skills; comfortable with speaking with families, payors and other key partners with respect and efficiency.
• Strong computer and IT skills with the ability to independently set up office equipment at a home workstation (remote workers).
• Strong proficiency with Google Suite products, billing software and electronic health records (EHR) systems.
• A thorough understanding of medical terminology, ICD-10, CPT coding (medical billing coding), and health insurance policies.
• Knowledge of insurance carriers billing procedures and requirements is highly preferred.
• Certification in Medical Billing and Coding is a plus.
• Knowledge of healthcare regulations and compliance
• Experience with coordination of concurrent reviews
• Uphold ethical standards in billing practices and ensure compliance with all applicable laws and regulations.

What We Offer

Unlimited PTO - for a team that’s rested, recharged and feeling their best

Full benefits including comprehensive medical, dental, vision and a 401K with up to 3% company match, fully vested after 3 years

Free in-house clinical trainings, DEIB trainings and yearly spending allowance for continuing education credits (CEUs)

Long term treatment model : Form deep therapeutic alliances and be a bigger part of your clients’ journeys (average client length of stay is 12 months)

Flexible, creative, team-based work environment in the heart of NYC and in an inspiring, centrally-located therapeutic setting

Limitless opportunities to expand your impact : work with our research team; support our groundbreaking student scholarship program;

be featured in the media on topics that matter or pilot a new treatment group At The Dorm, it's all possible!

We are family-owned and operated and proud to be a trusted, CARF-accredited organization

We are an equal opportunity employer. We consider applicants for all positions on the basis of merit, qualifications and business needs, and without regard to race, color, national origin, religion, sex, gender identity, age, disability, alienage or citizenship status, ancestry, marital status, partnership status, creed, sexual and reproductive health decisions, genetic predisposition or carrier status, sexual orientation, uniformed service or veteran status, familial status, status as a victim of domestic violence or any other status or characteristic protected by applicable federal, state or local law