Billing and Claims Specialist

Billing and Claims Specialist

Purpose

The Billing and Claims Specialist supports the accurate and timely billing of mental health services at Behavioral Health Clinic (BHC).

Position Summary

The Billing and Claims Specialist works with clinicians, administrative staff, patients, and insurance companies to submit and process insurance claims. This position also enters payments, prepares billing statements and reports, researches payer requirements, resolves billing issues, and supports patient collections.

Essential Duties and Responsibilities

• Oversee coding of services using ICD-10 and DSM-5 coding guidance.
• Submit claims through the electronic health record (EHR) and claims-processing software.
• Enter payments, including electronic remittance advice (ERA), electronic funds transfers (EFT), and other payment types.
• Prepare billing statements.
• Research and resolve billing issues by working with insurance companies.
• Run billing cycle reports.
• Research coding rules and regulations for contracted payers to help guide sound business practices.
• Support patient collections, including collecting copays and patient balances, issuing refunds, and managing the collections process.
• Perform other duties as assigned.

Minimum Required Qualifications

• Compassionate and able to handle confidential information responsibly.
• Able to learn and use computer software systems; training will be provided.
• Working knowledge of Microsoft Office and Google Workspace, including Docs and Sheets.
• Able to work effectively both independently and as part of a team.
• Willingness to learn and adapt.
• Strong organizational and time-management skills.
• Strong verbal and written communication skills, including professional phone skills.
• Willingness to work occasional overtime.

Preferred Qualifications

• Experience in medical coding or billing; this experience is preferred but not required.
• Three to five years of work experience preferred.

BHC Core Competencies

• Awareness: Understand yourself and others.
• Judgment: Evaluate information and make decisions in complex situations.
• Adaptability: Learn, adjust, and stay effective through change.
• Connection: Communicate, collaborate, and build trust.

Values

• Adaptability: We remain flexible, responsive, and resilient as the needs of our clients, team, and industry evolve.
• Collaboration: We foster strong partnerships and teamwork within and beyond the organization. We embrace learning and curiosity.
• Delivering Excellence: We set and achieve high standards and stay at the forefront of mental health in everything we do.
• Empathy: We put people first with kindness and understanding.
• Integrity: We uphold transparency, ethical practices, and accountability in our work.

Benefits

• Healthcare benefits, including dental, vision, short-term disability (STD), and long-term disability (LTD), plus retirement plan options.
• Paid time off (PTO) and holidays.
• Supportive, collaborative team environment.
• Opportunities for advancement and leadership.

Confidentiality and Required Training

This position has access to confidential employee, applicant, benefit, health, financial, and organizational information. The employee must use such information only for authorized business purposes and protect it in accordance with applicable laws, professional standards, and BHC policies. Required training may include new-hire orientation, HIPAA and privacy, information security, compliance, HR-system training, and other role-specific training assigned by BHC.

Physical Demands and Work Environment

This position primarily involves computer and telephone work in a professional office or approved remote-work environment. The employee must be able to communicate verbally and in writing, use standard office technology, maintain concentration amid routine interruptions, and occasionally stand, walk, reach, bend, or lift and carry office materials weighing up to 20 pounds. Reasonable accommodations may be provided as required by applicable law.

Equal Employment Opportunity

BHC is an equal opportunity employer. Employment decisions are made without regard to any characteristic protected by applicable federal, state, or local law. BHC provides reasonable accommodations during the application and hiring process as required by applicable law.

Employment Eligibility Verification

In accordance with legal requirements and company policies, successful candidates for this position must complete Form I-9, Employment Eligibility Verification, as part of BHC’s onboarding process.