About the Role:

POSITION SUMMARYThe Billing Specialist / Accounting Specialist is responsible for the accurate and timely billing, accounts receivable, payment posting, account reconciliation, and accounting support functions for the organization. The position plays a critical role in maintaining the financial health of the organization by ensuring that behavioral health services are properly documented, billed, collected, and reconciled.

The successful candidate must have prior healthcare billing experience and accounting experience, preferably within a behavioral health, substance use disorder treatment, community mental health, or other healthcare environment.

This position works closely with clinical, medical, administrative, and finance personnel to resolve billing issues, maintain accurate financial records, maximize reimbursement, and ensure compliance with payer requirements and organizational policies.

ESSENTIAL DUTIES AND RESPONSIBILITIESHealthcare Billing

Prepare and submit accurate claims to Medicaid, Medicare, commercial insurance companies, managed care organizations, and other third-party payers.Review claims for accuracy, completeness, appropriate coding, authorization, documentation, and payer requirements before submission.Verify patient/client insurance eligibility and benefits as needed.Monitor claim status and follow up on unpaid, rejected, and denied claims.Research and resolve billing errors, claim rejections, denials, and payment discrepancies.Submit corrected claims and appeals when appropriate.Maintain accurate billing records and supporting documentation.Monitor accounts receivable aging and prioritize collection activities.Identify recurring billing problems and recommend corrective actions.Communicate with clinical and administrative staff regarding missing documentation or information required for billing.Ensure services are billed within required payer and organizational timeframes.Maintain knowledge of applicable payer billing requirements and behavioral health reimbursement practices.

Accounts Receivable / Collections

Post insurance, Medicaid, Medicare, client, and other payments accurately and timely.Reconcile payments and remittance advices to submitted claims.Research and resolve outstanding accounts receivable balances.Maintain accurate aging reports.Track denials, underpayments, refunds, and outstanding balances.Assist with patient/client account balances and payment arrangements in accordance with organizational policies.Prepare accounts receivable reports for management review.Identify trends affecting collections and reimbursement.

Accounting Responsibilities

Perform routine accounting functions, including accounts receivable, payment posting, account reconciliation, and general ledger support.Reconcile billing records, deposits, payment reports, and accounting records.Assist with monthly financial close activities.Prepare and maintain spreadsheets, financial reports, and supporting documentation.Assist with bank and account reconciliations as assigned.Research discrepancies between billing, accounting, and financial records.Maintain organized financial documentation in accordance with organizational policies.Assist the Finance Director/CFO with audits, financial reporting, and other accounting projects.Support the preparation of documentation requested by auditors, funders, and regulatory agencies.

Compliance and Internal Controls

Maintain confidentiality of protected health information (PHI) and financial information in accordance with HIPAA and organizational policies.Follow applicable federal, state, Medicaid, Medicare, managed care, and commercial insurance billing requirements.Maintain accurate documentation to support billed services.Follow organizational internal controls related to billing, cash receipts, deposits, refunds, and financial transactions.Report suspected billing irregularities, compliance concerns, or potential fraud to appropriate management.Participate in internal and external audits as requested.Maintain knowledge of changes affecting behavioral health billing and reimbursement.

Customer Service and Team Collaboration

Provide professional and respectful customer service to clients, insurance representatives, healthcare providers, and organizational staff.Work collaboratively with clinical staff to resolve documentation and billing issues.Communicate effectively with supervisors and department leadership regarding billing and financial concerns.Protect client confidentiality and demonstrate professionalism when handling sensitive financial and healthcare information.

REQUIRED QUALIFICATIONSEducation

Associate degree in Accounting, Finance, Business Administration, Healthcare Administration, or a related field preferred.Equivalent combination of education and relevant professional experience may be considered.

Required ExperienceThe following experience is required:

Minimum of two (2) years of healthcare billing experience.Minimum of two (2) years of accounting or accounts receivable experience.Experience submitting and managing third-party healthcare claims.Experience with Medicaid and/or Medicare billing strongly preferred.Experience working with insurance denials, claim corrections, payment posting, and accounts receivable.Experience reconciling billing and accounting records.

Preferred Experience

Behavioral health billing experience.Substance use disorder treatment billing experience.Community mental health billing experience.Experience with Ohio Medicaid and/or Ohio behavioral health managed care billing.Experience with electronic health records (EHR) and practice management/billing systems.Experience working in a nonprofit healthcare organization.Experience supporting financial or compliance audits.