Full Time Billing & Claims Specialist

Job Title: Full Time Billing and Claims SpecialistReports to: Director of OperationsDescription: The Billing and Claims Specialist plays a key role in supporting the financial operations of Behavioral Health Clinic (BHC) by managing the full lifecycle of insurance claims and patient accounts. This position is responsible for submitting and processing claims, resolving denials, maintaining accurate accounts receivable, and supporting patient financial communications.This role also serves as a resource for patients by providing clear, compassionate guidance regarding billing, insurance coverage, and financial responsibility. The Billing and Claims Specialist works collaboratively with clinicians, front office staff, and insurance companies to ensure accurate billing practices, timely reimbursement, and a positive patient financial experience.Duties and Responsibilities: Claims & Billing OperationsSubmit insurance claims using the Electronic Health Record (EHR) and claims processing systemsOversee accurate coding of services using ICD-10 and DSM-5 guidelinesEnter and reconcile payments (ERA, EFT, and manual payments)Run billing cycle reports and monitor claim statusResearch payer policies, coding rules, and reimbursement guidelines to ensure compliancePrepare and distribute billing statementsDenials Management & Issue ResolutionReview, research, and resolve denied and rejected claimsWork directly with insurance companies to correct and resubmit claimsIdentify trends in denials and collaborate with internal teams to prevent future issuesCoordinate with front office and clinical staff to resolve documentation or insurance discrepanciesAccounts Receivable & Patient Financial ManagementReview patient accounts regularly to identify outstanding balances and initiate follow-upEnsure accurate setup of patient financial accounts, including correct insurance sequencing (primary/secondary)Contact patients regarding balances, insurance issues, or payment options via phone, email, and mailEstablish and monitor payment plans, including follow-up on missed paymentsAssist patients in understanding billing statements, EOBs, and financial responsibility with clarity and empathyManage patient collections processes, including preparation of accounts for third-party collections in alignment with clinic policiesServe as a point of contact for collection agency coordinationCompliance & DocumentationMaintain accurate and timely documentation of all account activity within the EHR and billing systemsEnsure compliance with HIPAA, financial privacy laws, and ethical billing practicesAdditional ResponsibilitiesCollaborate with internal teams to improve billing workflows and reduce errorsSupport patient experience through professional, solution-focused communicationOther duties as assignedQualifications:High school diploma or equivalent required; associate’s degree in healthcare administration, business, or related field preferred2–5 years of experience in healthcare billing, claims processing, or patient accounts preferredKnowledge of medical billing, coding, insurance processes, and accounts receivable workflowsExperience with EHR and billing systemsStrong attention to detail, organization, and time management skillsExcellent written and verbal communication skills, including patient-facing communicationAbility to work independently and collaborativelyProficiency in Microsoft Office and Google WorkspaceWillingness to learn, adapt, and work occasional overtimeBenefits:Starting pay range: $24.00 – $28.00 per hour (based on experience)Healthcare Benefit Package including Dental, Vision, STD, LTD, and Retirement Plan optionsSupportive and collaborative team environment with opportunities for advancementPaid Time Off (PTO) and HolidaysIn accordance with legal requirements and company policies, successful candidates for this position will be required to complete the form I-9, Employment Eligibility Verification, as part of the BHC Onboarding Process*