Job Description

Job Description

Job Description

Summary: This position will work with all phases of billing for a Mental Health / Substance Abuse Clinic. To be considered you must have at least 2-3 years’ experience in medical billing with a focus on payment posting and accounts receivable. The hours are Monday to Friday 8AM-4:00PM.

Why Work for SMOC?

• Paid Time Off: All full-time employees can accrue up to 3 weeks of vacation, and 2 weeks of sick time and are eligible for 12 paid holidays during their first year of employment.
• Employer-paid Life Insurance & AD&D and Long-Term Disability for full-time employees.
• Comprehensive Benefits Package including Medical Plans through Mass General Brigham with an HRA Employer cost-sharing program, Dental Plans with Orthodontic Coverage, and EyeMed Vision Insurance available to full-time employees.
• 403(B) Retirement Plan with a company match starting on day one for all full-time and part-time employees.
• Additional voluntary benefits including; Term and Whole Life Insurance, Accident Insurance, Critical Illness, Hospital indemnity, and Short-Term Disability.
• Flexible Spending Accounts, Dependent Care Accounts, Employee Assistance Program, Tuition Reimbursement and more.

Primary Responsibilities:

• Submit claims to payors, electronically or in paper form and verify receipt and acceptance by payors.
• Reconcile and resolve issues related to claims submissions.
• Confirm insurance eligibility and research and resolve eligibility issues.
• Post insurance checks and EOBs and reconcile posted totals.
• Review denials and partially paid claims and resolve discrepancies
• Reconcile cash payments in third party system with A&F financial system.
• Assist in resolving overdue claim problems.
• Obtain insurance authorizations from payors, including additional authorizations as needed.
• Monitor authorization report and send reminders to clinicians when additional visits and PAs are needed.
• Enter new client basic demographic information into billing system, as well as entering insurance and authorizations.

• Recommend patient balance write-off and process in billing system as directed
• Ensure compliance with program/department, agency and/or funder requirements, as well as, SMOC policies & procedures.
• Run reports and gather data as needed for financial and operating reports.
• Other duties as assigned.

Knowledge and Skill Requirements:

• Medical and/or Mental Health third party billing experience – min 3+ years required
• Experience with third party billing denial and resolution process.
• Associates Degree preferred
• Must have ability to handle multiple and changing priorities and meet deadlines

Organizational Relationship: Directly reports to Billing Manager. Direct reports to this position are none.

Physical Requirement: Ability to ascend and descend stairs. Ability to lift up to 10lbs.

Working Conditions: As part of the responsibilities of this position, the Medical Billing Specialist will have direct or incidental contact with clients served by SMOC in various programs funded or administered through the Executive Office of Health and Human Services

Remote Work Option: Remote work is permissible in some positions at SMOC depending on the key functions and responsibilities. The Medical Billing Specialist position is eligible to work from home 0-60% of the week in scheduling coordination with the department manager.

We are an equal opportunity employer committed to diversity in the workplace

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