Billing Specialist

Accountabilities: As a Billing Specialist, you will manage the medical billing and reimbursement process, ensuring claims are accurate, payment issues are resolved promptly, and all activities comply with established procedures and regulatory requirements. Prepare, review, and submit accurate claims to Minnesota Medical Assistance, managed care organizations, and commercial insurance providers while meeting payer-specific filing deadlines. Monitor assigned accounts receivable and claim statuses, investigate unpaid or underpaid claims, and follow up with payers to secure timely reimbursement. Analyze claim rejections and denials, correct billing errors, prepare appeals with supporting documentation, and track deadlines. Escalate unresolved or high-risk claims to the appropriate teams and stakeholders. Verify insurance eligibility and coverage, coordinating the resolution of authorization, provider enrollment, and other payer-related requirements. Maintain accurate client billing profiles, charges, payment postings, and adjustments in accordance with established procedures and approval limits. Respond to payer correspondence and documentation requests, ensuring all required records are submitted accurately and on time. Communicate professionally and respectfully with clients and families regarding insurance coverage and billing inquiries. Document claim follow-ups, payer communications, resolution efforts, and next steps in designated systems to maintain clear workflow visibility. Identify recurring billing issues, communicate findings to leadership, and contribute to approved process improvements. Collaborate with Revenue Cycle, Credentialing, Authorizations, and clinical teams to resolve reimbursement barriers. Support cross-training, backup coverage, and other billing activities while meeting established productivity and accuracy standards. Maintain the confidentiality of client information and ensure compliance with HIPAA and organizational policies. Perform additional assignments as requested by management and provide support across billing and reimbursement operations. Requirements: The ideal candidate has extensive medical billing experience, particularly with Minnesota Medical Assistance, and demonstrates strong expertise in claims resolution, accounts receivable management, and payer communication. You should be detail-oriented, organized, and comfortable managing priorities independently in a remote work environment. High school diploma or equivalent. At least 5 years of medical billing experience, including claims submission, accounts receivable follow-up, denial management, and appeals. Demonstrated experience billing Minnesota Medical Assistance (MA), including researching unpaid claims, resolving denials, and meeting payer requirements and filing deadlines. Experience working directly with Minnesota DHS or other state healthcare program representatives to resolve billing and reimbursement issues is preferred. Experience with professional billing using CMS-1500 claim formats, electronic claims submission, payer portals, and electronic remittance information. Familiarity with MN–ITS, EIDBI billing, and Minnesota Medicaid managed care plans is preferred. Ability to identify billing issues related to insurance eligibility, authorizations, provider enrollment, and documentation requirements. Experience in autism services, behavioral health, or outpatient healthcare billing is an advantage. Familiarity with CentralReach and a Certified Professional Biller (CPB) credential or equivalent certification is preferred. Experience with commercial insurance billing is preferred. Postsecondary education in healthcare administration, business, accounting, or a related field is an advantage. Proficiency in medical billing systems, electronic health records, Microsoft 365, and Excel for tracking and reviewing billing activities. Strong attention to detail, organizational abilities, analytical thinking, and problem-solving skills. Excellent written and verbal communication skills, with consistent documentation and follow-through. Ability to work independently in a remote environment while collaborating effectively with cross-functional teams. Must reside in Minnesota and successfully complete the required background checks. Benefits: Annual Salary: $51,200–$56,000, depending on experience and qualifications. Biweekly pay schedule. Medical insurance. Dental insurance. Vision insurance. Student Loan Repayment Program available after one year of employment. Fully remote work arrangement. Monday through Friday schedule, with working hours between 6:00 a.m. and 6:00 p.m. Central Time.