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CodeMax Behavioral Health Billing · 1 day ago

Claims Specialist (Substance Abuse Billing)

Fort Lauderdale, FL

Full-time

Onsite

New Grad, Entry Level

CodeMax Behavioral Health Billing is seeking a diligent Claims Follow-Up Specialist to ensure timely and accurate collection of medical claims. The role involves working closely with insurance companies to rectify payment denials and settle disputes while maintaining a comprehensive understanding of the insurance follow-up process.

BillingHealth CareOperating Systems

Responsibilities

Reviews and works on unpaid claims, identifying and rectifying billing issues

Communicates with insurance companies regarding any discrepancy in payments if necessary

Conducts research and appeals denied claims timely

Reviews Explanation of Benefits (EOBs) to determine denials or partial payment reasons

Provides detailed notes on actions taken and next steps for unpaid claims

Collaborates with the billing team to ensure accurate claim submission

Maintains a comprehensive understanding of the insurance follow-up process, payer guidelines, and compliance requirements

Resubmits claims with necessary corrections or supporting documentation when needed

Tracks and documents trends related to denials and work towards a resolution with the billing team

Assists patients with inquiries related to their insurance claims, providing clear and accurate information

All other duties as assigned

Qualification

Healthcare billing softwareMedical billing collectionsCPTICD-10 codingAnalytical skillsOrganizational skillsCommunication skillsHIPAABehavioral Health experience

Required

Proficiency in healthcare billing software

Strong analytical, organizational, and multitasking skills

Excellent verbal and written communication abilities

Ability to navigate payer websites and use online resources to resolve outstanding claims

High school diploma or equivalent required

Preferred

Experience in medical billing collections or a similar role in a Behavioral Health industry specializing in Substance abuse and Mental Health is strongly preferred

Knowledge of medical terminology, CPT and ICD-10 coding is a plus

Knowledge of HIPAA and other healthcare industry regulations