Job Title: Billing and Insurance Claims Specialist
Location: Therapy Insights Practice
About Therapy Insights Practice: Therapy Insights Practice is dedicated to providing exceptional mental health services. We are committed to supporting our clinicians and ensuring our billing and insurance processes are efficient and compliant. We are currently seeking a knowledgeable and experienced Billing and Insurance Claims Specialist to join our team. https://www.therapyinsightspractice.com/
Position Summary: The Billing and Insurance Claims Specialist is responsible for managing the billing processes and insurance claims for Therapy Insights Practice. This role requires extensive knowledge of insurance carriers, EHR systems, CPT and ICD codes, billing guidelines, and compliance. The specialist will work closely with clinicians, training and educating them on billing processes, and ensure accurate and timely submission of claims.
Key Responsibilities:
- Insurance Claims Management:
- Handle all aspects of insurance claims processing for various carriers.
- Ensure accurate and timely submission of insurance claims using multiple EHR systems such as Alma, Headway, Therapy Notes, and TherapyIQ.
- Verify insurance eligibility and benefits for patients.
- Address and resolve claim denials and discrepancies promptly.
- Billing Processes:
- Manage the entire patient billing cycle, including the importance of modifiers, location of service, CPT, and ICD codes.
- Ensure compliance with the most up-to-date billing and claims guidelines.
- Maintain expertise in billable and service codes.
- Training and Education:
- Train and educate clinicians on the billing process and documentation requirements.
- Provide updates on any changes in billing guidelines and insurance policies.
- Compliance and Audits:
- Conduct regular audits of billing and claims processes to ensure compliance with provider and EHR requirements.
- Familiarity with PHI compliance, particularly regarding Stripe payment methods.
- Improving Billing Efficiency:
- Implement strategies to significantly reduce backbilling and backlogs.
- Improve turnaround times from insurance claim submissions to insurance claim approval.
- Manage client aging balance summaries and ensure timely follow-up.
- Credentialing and Rate Negotiations:
- Knowledgeable in the credentialing process for providers.
- Expert in negotiating insurance rates to maximize reimbursement.
- Incident-To and Supervisory Billing:
- Familiar with incident-to billing and supervisory billing guidelines and ensure adherence to these practices(Incident to billing (1)).
Qualifications:
- Education: High school diploma or equivalent required; Bachelor’s degree in Business, Healthcare Administration, or related field preferred.
- Experience:
- Minimum of 3-5 years of experience in medical billing and insurance claims processing.
- Extensive knowledge of insurance carriers and billing guidelines.
- Proficiency in multiple EHR systems, including Alma, Headway, Therapy Notes, and TherapyIQ.
- Proven track record of reducing backbilling and backlogs, and improving claim turnaround times.
- Skills:
- Strong understanding of CPT and ICD codes.
- Excellent communication and interpersonal skills.
- Detail-oriented with strong organizational and multitasking abilities.
- Ability to work independently and as part of a team.
- Proficient in using billing software and Microsoft Office Suite.
Compensation and Benefits:
- Competitive $45,000 - $60,000, commensurate with experience.
- Comprehensive benefits package, including health insurance, retirement plans, and paid time off.
- Opportunities for professional development.
How to Apply: Interested candidates should submit a resume and cover letter outlining their qualifications and experience to Chief Operating Financial Officer, Albert Ramos, at aramos@therapyinsightspractice.com
LinkedIn Profile should be updated to be considered
Job Type: Full-time
Pay: $40,000.00 - $60,000.00 per year
Benefits:
- Dental insurance
- Flexible schedule
- Health insurance
- Paid time off
- Vision insurance
- Work from home
Schedule:
Work setting:
Work Location: Remote