Job Description

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.

Job Tags

Full time, Work from home, Flexible hours

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