The Billing Specialist supports Revenue Operations by managing medical billing processes, including coding, payment posting, accounts receivable aging, and denial follow-up. This role ensures accurate and timely processing of claims and payments across Electronic Health Records (EHR) and Practice Management Systems (PMS).
- Billing and management of claims for multiple programs and payers to achieve maximum reimbursement
- Maintain working knowledge of multi-state payer rules, including Medicaid/MCOs, commercial insurance, third-party liability, state contracts, grants, and inter-organizational billing requirements
- Ensure claims are submitted timely and in compliance with payer requirements, reviews remittance advice to identify underpayments or discrepancies
- Reduce rejections and denials by scrubbing claims for timely and accurate submission
- Manages the resolution of insurance claim denials through detailed review, correction, and resubmission to optimize revenue recovery
- Collaborates with internal teams to resolve billing issues and improve workflows
- Manages aging accounts by contacting commercial payers and state programs to ensure timely and accurate payment
- Monitors aging reports to prioritize follow-up efforts
- Identifies, verifies, and submits claims to secondary and tertiary insurance carriers to maximize reimbursement
- Accurately posts insurance and patient payments into Practice Management Systems (PMS)
- Prepares and maintains Excel worksheets, tracking tools, and ad hoc reports to support revenue cycle operations
- Prepares, or assists in the preparation of, financial reports, analyses, and special projects as needed
- Conducts follow-up with payers to resolve denials, rejections, and unpaid claims
- Maintain and manage Billing workflows across assigned programs to ensure efficient and consistent operations
- Reviews accounts to determine if adjustments are necessary
- High School diploma or equivalent
MINIMUM EXPERIENCE & REQUIREMENTS:
- Minimum of two years of billing experience in a healthcare setting, behavioral health preferred
- Must be 21 years of age
- Must have a valid Driver’s License
- Must pass a drug screen, MVR, and Child Abuse and Neglect Central Registry clearance check
- Lifting Requirements of 30-50 lbs
Skills Required
- High school diploma or equivalent
- At least two years of billing experience in a healthcare setting
- Behavioral health billing experience
- Must be at least 21 years of age
- Valid driver's license
- Pass a drug screen
- Pass an MVR check
- Pass a Child Abuse and Neglect Central Registry clearance check
- Ability to lift 30 to 50 pounds
What We Do
SFM is a people-first company of curious thinkers, problem-solvers, and creators specializing in AV and technology. They foster a collaborative, inclusive, and growth-focused environment where employees are empowered to grow. Known for a supportive community and a culture of innovation, SFM offers a unique workplace experience that includes a 4-day work week, hybrid work options, and professional development opportunities.
