Billing Specialist

Position Overview

The Medical Billing Specialist manages the billing and administrative referral processes that support Connected Communities’ mental health services. The Medical Billing Specialist will submit claims, verify insurance, post payments, follow up on unpaid balances, and manage billing records. There is potential for this to be a hybrid position, allowing for both in-office and remote work.

Essential Functions

• Log, track, and enter administrative referral information into the electronic medical record.
• Verify insurance eligibility, coverage, authorizations, and payer information.
• Prepare and submit routine outpatient claims daily.
• Complete monthly CSA billing accurately and by established deadlines.
• Review service documentation and apply appropriate ICD-10 and CPT codes.
• Post insurance payments, patient payments, and electronic funds transfers in the EMR and QuickBooks or QuickBooks Online.
• Reconcile payment, billing, and account information between the EMR and QuickBooks or QuickBooks Online.
• Monitor accounts receivable and follow up on unpaid balances.
• Investigate denied or underpaid claims and submit corrections or appeals when appropriate.
• Maintain accurate and organized billing records.
• Prepare monthly billing reports covering claims, payments, denials, outstanding balances, follow-up activity, and unresolved issues.
• Communicate recurring payer, documentation, coding, or billing issues to the Operations Director.
• Protect confidential and protected health information in accordance with organizational procedures and applicable requirements.
• Other job duties as assigned

Qualifications

Required

• High school diploma or equivalent.
• At least two years of experience in medical billing or mental-health billing.
• Proficiency with billing software, electronic medical record systems, and QuickBooks or QuickBooks Online.
• Knowledge of ICD-10 and CPT coding and familiarity with insurance policies and procedures.
• Ability to handle sensitive and confidential information with discretion.

Preferred

• Bachelor’s degree.
• Certification in medical billing or coding, such as CPC, CPC-A, or CPB.
• Experience with mental-health billing and insurance.
• Knowledge of Medicaid and Medicare billing regulations.
• Familiarity with electronic claims submission and clearinghouses.
• Proficiency in Ensora

Physical & Work Requirements

The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this position, with or without reasonable accommodation.

This position operates in office and school-based environments and may include travel within the community. The role routinely requires:

• Prolonged sitting and computer use
• Frequent standing and walking in school or community settings
• Bending, reaching, and light lifting (up to 25 pounds)
• Clear verbal communication with clients, families, and staff
• Safely entering and exiting vehicles

Equal Employment Opportunity

Connected Communities is an Equal Opportunity Employer committed to a safe, respectful, and inclusive workplace. We comply with all applicable federal, state, and local employment laws, including equal employment opportunity and OSHA safety standards. We prohibit discrimination, harassment, and retaliation in any form and expect all employees to contribute to a professional and safe work environment.

Benefits:

Medical

Dental

Vision

Short Term and Long Term Disability.

Life Insurance

Job Type: Full-time

Pay: $20.00 - $25.00 per hour

Benefits:

• Dental insurance
• Flexible schedule
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Work Location: Hybrid remote in Winchester, VA 22601