Outpatient Billing Specialist

About ICGH

Integrated Care for Greater Health (ICGH) is a recovery-focused organization that grew from Hickory, North Carolina, into a growing continuum of services designed to support lasting recovery. We connect community clinics, inpatient and mobile integrated care, telehealth, pharmacy and medication access, peer support, recovery housing, transportation, and care navigation.

Our guiding philosophy is "Recovery—not treatment." We believe in creating connected, accessible services that support individuals wherever they are in their recovery journey.

Position Overview

The Outpatient Billing Specialist is responsible for preparing, submitting, and managing insurance claims for outpatient behavioral health services. This position ensures accurate and timely claim submission, monitors accounts receivable, and follows up on unpaid, rejected, and denied claims to support timely reimbursement.

Key Responsibilities

• Review outpatient charges and supporting documentation for accuracy and completeness prior to billing.
• Verify insurance eligibility, benefits, authorization requirements, and payer-specific billing guidelines as needed.
• Ensure accurate coding and billing using appropriate CPT, HCPCS, ICD-10, modifier, and place-of-service codes.
• Prepare and submit claims to North Carolina Medicaid, Medicaid MCO plans, Medicare, and commercial insurance payers within required filing deadlines.
• Monitor claim statuses and accounts receivable to identify outstanding, rejected, and denied claims.
• Research and resolve billing issues, including claim rejections, denials, and underpayments.
• Prepare and submit corrected claims and appeals within payer deadlines.
• Communicate with clinicians, supervisors, and insurance representatives to resolve billing and documentation issues.
• Maintain accurate billing records and support compliance with payer requirements and organizational policies.

Required Qualifications

• High school diploma or equivalent.
• Minimum of 1–2 years of medical billing experience.
• Knowledge of medical billing practices, insurance claims, and accounts receivable follow-up.
• Familiarity with North Carolina Medicaid, including Medicaid Managed Care Organization (MCO) plans, as well as Medicare and commercial insurance billing.
• Experience using electronic health record (EHR) or practice management systems.
• Strong attention to detail, organization, and time management.
• Ability to manage multiple priorities and meet deadlines.

Preferred Qualifications

• Experience with behavioral health or substance use service billing.
• Familiarity with Intensive Outpatient Program (IOP) and Substance Abuse Comprehensive Outpatient Treatment (SACOT) billing.
• Knowledge of behavioral health billing codes, modifiers, authorization requirements, and payer guidelines.

Skills & Abilities

• Strong analytical and problem-solving skills.
• Effective written and verbal communication.
• Ability to work independently and collaboratively.
• Professionalism and discretion when handling confidential information.
• Proficiency in Microsoft Office, particularly Excel and Word.