Behavioral Health Biller

Job description

Family Access Center is hiring a Behavioral Health Biller to join our team, supporting and empowering individuals to overcome life's challenges by providing quality services in our Sioux City office.

Key Responsibilities

Claim Scrubber & Correction (Primary Focus)

• Audit & Edit: Review, troubleshoot, and correct rejected, denied, or unpaid insurance claims via the clearinghouse or insurance portals.
• Appeals Management: Investigate the root causes of claim denials (e.g., prior authorization issues, coordination of benefits, coding errors) and submit formal appeals with necessary medical documentation.
• Payment Posting & Reconciliation: Accurately post insurance payments (ERAs/EOBs) and patient payments to patient accounts, identifying any underpayments or processing errors.

Daily Billing Operations

• Claim Submission: Prepare, review, and electronically submit daily clean claims for commercial insurance, Medicaid, Medicare, and managed care organizations (MCOs).
• Coding Compliance: Verify that clinicians have documented correct ICD-10 diagnostic codes and mental health CPT codes (e.g., 90834, 90837, 90791) along with appropriate modifiers (e.g., 95 for telehealth).
• Eligibility Verification: Confirm client insurance eligibility, mental health benefits, copays, deductibles, and track required prior authorizations.

Account & Client Management

• Accounts Receivable (A/R) Tracking: Monitor the aging A/R report to actively follow up on outstanding claims over 30, 60, and 90 days old.
• Patient Billing Support: Answer client inquiries regarding statements, deductibles, coverage discrepancies, and coordinate payment plans.
• Provider Feedback: Communicate regularly with clinical staff to resolve missing documentation, signature requirements, or recurring coding errors.
  

Required Qualifications & Skills

• Experience: 2+ years of dedicated medical billing experience, with a strict preference for mental/behavioral health billing.
• Technical Savvy: Proficiency utilizing Electronic Health Record (EHR) systems and billing clearinghouses (e.g., SimplePractice, TherapyNotes, Kareo, Waystar, Availity).
• Industry Knowledge: Strong familiarity with mental health CPT billing codes, modifiers, DSM-5/ICD-10 crosswalks, and timely filing limits.
• Analytical Skills: High proficiency in reading and interpreting complex Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs).
• Communication: Strong verbal and written communication skills for negotiating with insurance representatives and speaking empathetically with patients.
• Certification (Preferred): Certified Medical Coder (CMC) or Certified Professional Biller (CPB) designation is a plus.

Benefits:

• Tuition Assistance
• Paid Time Off
• Holiday Pay
• Health Insurance
• Life Insurance
• 401(k) plan
• 401(k) matching
• Referral Bonus

Job Types: Full-time

Salary: $22–28 per hour

Work Location: 1221 Pierce St., Sioux City, IA, 51105