Abria Recovery is seeking a detail-oriented Billing Specialist to support the billing operations for our outpatient substance use disorder treatment program (245G). This hands-on position is responsible for insurance verification, claim submission, payment posting, denial follow-up, accounts receivable and client billing. The Billing Specialist will utilize the
Procentive electronic health record while ensuring compliance with Minnesota DHS regulations, payer requirements, and organizational policies.
Essential Responsibilities:
- Verify insurance eligibility and benefits prior to the start of services.
- Submit electronic insurance claims and client invoices accurately and timely through Procentive.
- Audit claims prior to submission to ensure accurate coding, documentation, and payer requirements are met.
- Follow up on rejected, denied, and unpaid claims to secure timely reimbursement.
- Research claim denials, make corrections, and submit appeals or corrected claims as appropriate.
- Accurately post insurance payments, client payments, contractual adjustments, and payment corrections.
- Reconcile Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs).
- Monitor accounts receivable and follow up on outstanding insurance and client balances.
- Complete required DAANES data entry accurately and within required timeframes.
- Monitor payer updates and maintain current payer information within the billing system.
- Respond professionally to client and payer inquiries regarding billing, insurance coverage, invoices, and payment questions.
- Collaborate with admissions, clinical, and administrative staff to resolve billing and documentation issues.
- Conduct daily claim audits to ensure billing accuracy and compliance.
- Maintain compliance with HIPAA, Minnesota DHS regulations, and organizational policies.
- Identify opportunities to improve billing accuracy, reduce denials, and enhance billing workflows.
Qualifications
- High school diploma or equivalent required; Associate's degree in Healthcare Administration, Business, Accounting, or a related field preferred.
- Minimum of two years of medical billing experience, preferably in behavioral health or substance use disorder treatment.
- Experience with Procentive or similar electronic health record/billing systems preferred.
- Knowledge of Minnesota Medicaid (MHCP), commercial insurance billing, and DAANES reporting preferred.
- Strong attention to detail, organizational skills, and problem-solving abilities.
- Excellent communication and customer service skills.
- Ability to work independently while managing multiple priorities and deadlines.
Work Location
This is a
fully remote position. Employees must maintain a reliable high-speed internet connection and a private, HIPAA-compliant workspace. Attendance at one mandatory Microsoft Teams meeting each month is required.
Flexible work from home options available.