Mental Health Billing & Insurance Eligibility Specialist

Key Responsibilities

• Submit accurate and timely insurance claims
• Verify patient insurance eligibility and benefits
• Calculate and collect patient financial responsibility
• Prepare and send patient statements and invoices
• Obtain referrals and pre-authorizations prior to services
• Monitor accounts receivable and record late payments
• Follow up on unpaid or denied claims
• Investigate and appeal claim denials
• Review patient bills for accuracy and completeness
• Maintain billing systems, including payer IDs, rate updates, and reporting
• Prepare billing productivity and collection reports

Required Qualifications

• Minimum 2 years of medical billing experience (mental health preferred)
• Stable, long-term employment history required
• Strong knowledge of insurance portals (Medicare, Medicaid, Tricare, Optum, etc.)
• Experience verifying eligibility and confirming provider paneling
• Ability to work independently and manage multiple tasks efficiently
• Excellent organizational and problem-solving skills

Preferred Skills & Experience

• Experience with SimplePractice EHR system
• Proficiency in Microsoft Excel
• Knowledge of CPT and ICD-10 coding (Mental Health, ABA, Psychological Testing)
• Familiarity with Centers for Medicare and Medicaid Services (CMS) guidelines
• Experience with Availity for insurance verification and medical records submission
• Background in:
• Accounts Receivable (A/R) billing
• Secondary insurance billing
• Superbill preparation and submission
• Medical collections
• EHR and medical records management
• HIPAA compliance

Additional Responsibilities

• Data collection and reporting for insurance panels
• Ensuring compliance with billing regulations and payer requirements
• Maintaining accurate and up-to-date patient records