Billing Specialist

POSITION TITLE: Billing Specialist
REPORTS TO: Business Office Manager
FLSA STATUS: Exempt
SCHEDULE: Monday–Friday, 8:00AM-5:00PM

POSITION SUMMARY

All Together Recovery LLC (ATR) provides multiple levels of ASAM SUD/BHSO care, including recovery housing, education, job training, employment, and other recovery related extensions to the family in both for-profit and non-profit environments. The Billing Specialist is responsible for accurately preparing, submitting, and tracking billing claims and payments. This role ensures timely reimbursement by maintaining compliance with payer regulations, resolving billing discrepancies, and supporting overall revenue cycle operations.

The Billing Specialist works closely with clinical, administrative, and financial teams to ensure accurate documentation, efficient workflows, and excellent customer service.

KEY PERFORMANCE INDICATORS (KPIs) Billing & Claims Management

• Prepare and submit initial claims to insurance payers. KPI: 100% of claims submitted within 24 hours.
• Follow up on outstanding, denied, or rejected claims. KPI: 100% of denied and rejected claims resubmitted within 48 hours.
• Ensure 100% of claims worked within daily productivity.
• Process adjustments, rebills, and corrections as needed. KPI: < 98% of claims reconciled with insurance payments.
• Maintain organized records of all billed and pending claims. KPI: < 98% of claims in the correct payer status.

Payment Posting & Reconciliation

• Accurately post payments, adjustments, and remittances. KPI: 100% of EOB/ERAs posted accurately.
• Research and resolve payment discrepancies, underpayments, and over payments. KPI: < 98% of payment issues resolved accurately.
• Reconcile daily, weekly, and monthly billing reports to ensure accuracy. KPI: 100% of billing reports submitted to Business Office Manager.

Administrative & Miscellaneous

• Scan, organize, and maintain digital and physical correspondence including EOBs, denials, approvals, and payer letters. KPI: 100% of correspondence sorted.
• Prepare and mail invoices and other correspondence to patients and guarantors. KPI: 100% of invoices mailed monthly.
• Assist with answering incoming phone calls and direct to appropriate departments. KPI: 100% of phone calls answered.
• Assist with other duties as assigned by Business Office Manager.

ADDITIONAL PERFORMANCE EXPECTATIONS

• Demonstrates leadership and integrity in all interactions.
• Models servant leadership and fosters a culture of recovery and respect.
• Engages in continuous quality improvement for daily office operations.

SUPERVISORY RESPONSIBILITIES

This position has no supervision responsibilities.

BACKGROUND / EDUCATION

• The applicant must have a minimum of a high school diploma or GED.
• Minimum of 2-3 years’ experience working in billing, revenue cycle, or another related field preferred. An associate degree is preferred but not required.
• Experience working in behavioral health field preferred.
• Previous experience working with KIPU, Collab
  
  MD, Availity, and KYMMIS preferred.

QUALIFICATION REQUIREMENTS

Must have knowledge of medical privacy and confidentiality (HIPAA), computer applications/software to include Microsoft Office programs/MS Outlook, and internet familiarity, along with Dropbox and EHR preferred. Experience working with individuals and families who have various mental, behavioral, and substance use conditions.

SKILLS REQUIRED

Must have the knowledge, skills, and abilities to perform the essential functions of the job.

Must have excellent customer service skills.

Must have organizational skills with attention to detail.

Must have strong communication skills both verbal and written.

Maintain effective interpersonal relationships.

Must have the ability to work independently, and in a demanding and busy environment.

Must have the ability to multitask and have a proficient handle on completing tasks within an assigned timeframe.

WORKING CONDITIONS Physical Demands

Must be able to sit, stand, bend, reach overhead and lift to 50 pounds; travel outside the office and/or attend meetings both during and after normal work hours, both at and away from the worksite. May involve walking or standing for brief periods of time. Requires about 3 hours of…