All In Solutions, LLC · 7 hours ago
Billing Specialist - Substance Abuse Treatment Operations
All In Solutions is dedicated to providing quality, evidence-based treatment for long-term recovery. They are seeking a Billing Specialist who will manage full cycle billing, resolve outstanding claims issues, and ensure compliance with billing regulations in the substance abuse treatment domain.
Business DevelopmentInformation TechnologyIT Management
Responsibilities
Verify insurance eligibility and detailed behavioral health benefits (deductibles, co-pays, out-of-pocket max) for all new admissions
Ensure accurate ICD-10 and CPT coding for substance abuse and mental health services, including the use of appropriate modifiers
Prepare and submit electronic and paper claims using UB-04 and CMS-1500 forms to commercial and government payers
Review and scrub claims for accuracy prior to submission to minimize clearinghouse rejections and denials
Manage the Accounts Receivable (A/R) aging report and perform consistent follow-up on outstanding claims beyond 30 days
Identify, analyze, and appeal denied or underpaid claims by submitting corrected claims or formal letters of medical necessity
Coordinate with the Utilization Review (UR) department to ensure billing stays aligned with authorized days and levels of care
Post insurance and patient payments to the billing system and reconcile daily deposits with bank statements
Communicate with insurance adjusters and representatives to resolve complex billing discrepancies or contract issues
Maintain up-to-date knowledge of HIPAA regulations and behavioral health parity laws to ensure facility compliance
Generate weekly and monthly financial reports for management, including revenue projections and collection rates
Update and maintain the facility's Charge Master and payer contracts within the billing software/EHR
Qualification
Required
Familiarity with regulatory requirements: NJ: NJAC 10:161A/B – Billing compliance for SUD facilities, FL: FAC 65D-30 – Billing documentation and reporting requirements, CA: Title 9 CCR, Chapter 11 – SUD billing and recordkeeping
Exceptional attention to detail and an eye for spotting errors and discrepancies
Strong communication and customer service skills with the ability to see issues through to resolution
Intermediate to advanced levels of skills in Google Suite and/or Microsoft Office and a proven aptitude for computers
Strong understanding of current ICD-10, CPT and HCPCS coding practices
Familiarity with HIPAA privacy laws and the Mental Health Parity and Addiction Equity Act (MHPAEA)
Preferred
Preferred understanding of ASAM (American Society of Addiction Medicine) criteria and how it relates to billing levels of care
Experience with Kipu and CollaborateMD
Benefits
401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance
Company
All In Solutions, LLC
All In Solutions, LLC is an SBA certified SDVOSB, and WOSB specializing in IT Managed Services Delivery (MSD), and Problem Exploration and Solutioning in an integrated approach across the areas of people, process and technology.