Billing Specialist - Substance Abuse Treatment Operations (49197)

About Us – Mission & Values

At All In Solutions, our mission is to provide quality, evidence-based treatment that leads to long-term recovery for every client who walks through our doors. We believe that connection and purpose are essential to this pursuit, guiding every decision we make and every service we provide.

Position Summary

The Billing Specialist will be able to complete full cycle billing as well as resolve outstanding claims issues. They will be well versed in the ability to verify benefits as well as resolve outstanding AR.

Key Responsibilities

• Coding & Compliance: Ensure accurate ICD-10 and CPT coding for substance abuse and mental health services, including the use of appropriate modifiers.
• Claims Submission: Prepare and submit electronic and paper claims using UB-04 and CMS-1500 forms to commercial and government payers.
• Quality Control: Review and scrub claims for accuracy prior to submission to minimize clearinghouse rejections and denials.
• A/R Management: Manage the Accounts Receivable (A/R) aging report and perform consistent follow-up on outstanding claims beyond 30 days.
• Denials & Appeals: Identify, analyze, and appeal denied or underpaid claims by submitting corrected claims or formal letters of medical necessity.
• Cross-Department Collaboration: Coordinate with the Utilization Review (UR) department to ensure billing stays aligned with authorized days and levels of care.
• Payment Posting: Post insurance and patient payments to the billing system and reconcile daily deposits with bank statements.
• Payer Relations: Communicate with insurance adjusters and representatives to resolve complex billing discrepancies or contract issues.
• Compliance Maintenance: Maintain up-to-date knowledge of HIPAA regulations and behavioral health parity laws to ensure facility compliance.
• Financial Reporting: Generate weekly and monthly financial reports for management, including revenue projections and collection rates.
• System Updates: Update and maintain the facility's Charge Master and payer contracts within the billing software/EHR.