Mental Health Billing Specialist in Edgewater, Maryland at Arundel Lodge, Inc.

Arundel Lodge is seeking an experienced and detail-oriented Mental Health Billing Specialist to support our medical billing and revenue cycle operations.

The Billing Specialist will be responsible for authorization management, insurance verification, claims submission, payment posting, account reconciliation, and follow-up on claim denials and billing discrepancies. This position works closely with clinical, administrative, and finance teams to ensure services are properly authorized, accurately billed, and reimbursed in a timely manner.

The ideal candidate has strong knowledge of mental health and healthcare billing, excellent attention to detail, strong problem-solving skills, and the ability to independently research and resolve billing issues while maintaining confidentiality.

• Track, request, obtain, and enter insurance authorizations for Medical Assistance and commercial insurance plans across Outpatient Mental Health, Residential, Supported Employment, and Substance Abuse programs.
• Submit and manage authorization requests through the Carelon Provider Portal.
• Monitor authorization status and follow up on denials, pending requests, expirations, and requests for additional clinical information.
• Initiate, review, and monitor claims through the Credible EHR/billing platform.
• Review claims for accuracy and completeness before submission and identify potential issues that could result in rejection or denial.
• Research, resolve, document, and track claim discrepancies, rejections, denials, and payment issues.
• Monitor claim status and communicate with insurance payers and clearinghouses to support timely reimbursement.
• Verify Medical Assistance eligibility for residential and outpatient persons served and address eligibility issues as needed.
• Receive, record, and accurately post payments, including cash, checks, and credit card payments.
• Issue monthly statements and respond professionally to billing questions, account inquiries, and complaints.
• Maintain accurate and organized billing records and documentation.
• Provide backup support for billing, claims processing, authorization, data entry, and other revenue-cycle functions.
• Collaborate with clinical, administrative, finance, and billing staff to resolve authorization, eligibility, claims, and account-related issues.
• Maintain confidentiality and comply with HIPAA, payer, organizational, and billing requirements.
• Stay current with healthcare regulations, insurance requirements, billing procedures, and payer guidelines.
• Perform other billing and administrative duties as assigned.

• High school diploma or equivalent required.
• Minimum of 4 years of relevant experience in mental health medical billing, healthcare revenue cycle, claims processing, insurance verification, and/or data entry.
• Medical billing or coding certification preferred.
• Experience working with Electronic Health Record (EHR) systems; Credible experience strongly preferred.
• Experience with Waystar, Carelon, Availity, EVS, and Novitsphere preferred.
• Knowledge of Medical Assistance, commercial insurance, authorization requirements, claims processing, denials, and coordination of benefits.
• Proficiency with Microsoft Office Suite, including Word, Excel, and Outlook.
• Strong organizational and time-management skills.
• Excellent attention to detail and accuracy.
• Ability to prioritize multiple assignments and meet deadlines.
• Strong analytical, research, and problem-solving skills.
• Excellent written and verbal communication skills.
• Strong customer-service skills and the ability to communicate professionally with persons served, insurance companies, clinical staff, and internal departments.
• Ability to work independently with minimal supervision while contributing effectively as part of a team.
• Ability to maintain confidentiality and appropriately handle sensitive financial and personal information.

The successful candidate will be a highly organized and dependable professional who:

• Understands the complexities of mental health and healthcare billing.
• Is comfortable researching and resolving difficult claims and authorization issues.
• Pays close attention to details and takes ownership of accurate billing.
• Can manage multiple priorities while meeting important deadlines.
• Communicates professionally with insurance companies, staff, and persons served.
• Works well independently while collaborating effectively with a multidisciplinary team.
• Demonstrates discretion and maintains strict confidentiality when handling sensitive information.

This is an opportunity to use your billing and revenue-cycle expertise in a mission-driven behavioral health organization. Your work directly supports the financial health of the organization and helps ensure that the programs and services provided to the people we serve can continue to make a meaningful impact.

If you have healthcare or mental health billing experience, strong attention to detail, and the ability to effectively manage authorizations, claims, payments, and denials, we encourage you to apply for the Mental Health Billing Specialist position at Arundel Lodge.

Join our team and help support the systems that make quality behavioral health services possible.