Medical Billing Specialist

Medical Billing Specialist (Remote - Oregon/Southern Washington)

Help ensure clients can access care by making the billing process accurate, efficient, and seamless. We are seeking a detail-oriented Medical Billing Specialist who takes ownership of results and delivers exceptional service. In this role, you'll support both our clients and our organization by ensuring claims are processed accurately, reimbursements are collected promptly, and accounts are managed professionally and compliantly.

Success is measured through achievement of established productivity, quality, accuracy, compliance, and customer service standards while contributing to a respectful, collaborative workplace.

This position is approved for remote work within Oregon and Southern Washington. Employees must maintain a dedicated, private workspace that supports confidentiality and HIPAA compliance. They must also have reliable high-speed internet capable of supporting video conferencing and cloud-based systems, professional availability during established business hours, the ability to participate in virtual meetings, training, and collaboration activities using agency-provided technology, and residency within Oregon or the designated Southern Washington service area.

Occasional travel to Klamath Falls, Oregon may be required for onboarding, training, department meetings, and other business needs.

In this role, you will submit accurate, timely claims for commercial insurance, Medicaid, Medicare, and client-pay accounts. You will resolve denied, unpaid, and underpaid claims to maximize reimbursement. You will maintain clean accounts receivable and proactively reduce aging balances. You will provide responsive, professional support to clients regarding billing and account questions. You will consistently meet productivity, quality, compliance, and customer service expectations.

You will partner effectively with internal teams, payers, and external stakeholders to improve outcomes and processes.

Key responsibilities include submitting and managing billing for commercial insurance, Medicaid, Medicare, and direct-pay accounts. You will investigate and resolve denied, unpaid, and underpaid claims. You will process service authorizations and support timely reimbursement for approved services. You will manage follow-up, collections, and denial resolution activities while meeting established performance standards.

You will post payments, reconcile accounts, process refunds, prepare statements, and support month-end activity. You will monitor aging reports and perform collection activities in accordance with agency policies. You will communicate account status, reimbursement trends, and collection efforts as needed.

You will process financial assistance applications and verify eligibility. You will respond to billing inquiries with professionalism, empathy, and accuracy. You will escalate complex account issues for additional review when necessary.

You will maintain accurate billing, reimbursement, collections, and financial records. You will ensure compliance with federal, state, payer, and agency requirements. You will protect confidential client and organizational information in accordance with HIPAA and agency policies.

You will participate in meetings, training, and professional development activities. You will stay current on billing regulations, reimbursement requirements, and industry changes. You will contribute to process improvement initiatives that enhance efficiency, service quality, and compliance. You will demonstrate professionalism, accountability, integrity, and respect in all interactions.

Preferred qualifications include two or more years of medical billing and coding experience, preferably in behavioral health, mental health, substance use disorder treatment, community mental health, or psychiatric services. You should have working knowledge of CPT, HCPCS, ICD-10-CM coding, modifiers, authorizations, and payer reimbursement requirements. Experience billing Oregon Medicaid behavioral health services and Medicare mental health services is strongly preferred. You should have knowledge of accounts receivable management,…