Medical Billing and A/R Follow-Up Specialist (IL, Behavioral)
This is a remote position.
Job Summary We are hiring a full-time Medical Billing and A/R Follow-Up Specialist to support a psychiatry practice based in Illinois. You will handle professional claims from submission to payment across inpatient psychiatric, skilled nursing, rehabilitation, intensive outpatient, and outpatient settings. That includes submitting clean claims, working rejections and denials, following up on unpaid and underpaid claims, and posting payments. This role requires strong attention to detail, persistent follow-up, and experience working with U.S. health insurance plans, including Medicare and Medicaid.
Key Responsibilities
- Verify eligibility, benefits, and coordination of benefits, and confirm authorization requirements for intensive outpatient and inpatient services
- Prepare and submit professional claims, confirming the correct place of service, provider, facility, and date of service
- Work clearinghouse rejections and front-end edits daily, correcting and resubmitting claims the same day where possible
- Follow up on unpaid claims by payer portal and phone, prioritizing aged claims and those at risk of missing a deadline
- Work on denials using remittance advice and denial codes, then correct claims and file timely appeals and reconsiderations
- Track timely filing and appeal deadlines by payer so that no claim is lost to a filing limit
- Post and reconcile payments from ERAs and EOBs, and flag underpayments against fee schedules for review
- Report recurring denial patterns by payer, provider, and reason code to the practice’s billing leadership
- Document every action clearly in the billing system
- Protect patient information and follow HIPAA requirements
Qualifications
- At least 2 years of experience with U.S. healthcare insurance billing and A/R follow-up
- Hands-on experience with claim submission, denial management, and appeals, including reading denial and remark codes
- Familiarity with commercial insurance and government health plans, including Medicare, Medicaid, managed Medicaid, and Medicare Advantage
- Experience using payer portals and insurance websites
- Working knowledge of electronic claims and remittance (837/835, ERA/EOB)
- Basic Excel skills for tracking A/R and denials
- Strong written and spoken English
- Excellent attention to detail and follow-up skills
- Ability to work independently and manage a large queue of claims across multiple payers
- Reliable internet connection and a suitable remote workspace
Preferred Qualifications
- Familiarity with Illinois Medicaid/Medicare and its managed care plans
- Experience supporting psychiatry or behavioral health practices
- Familiarity with psychiatric CPT codes, such as hospital care, nursing facility visits, psychiatric diagnostic evaluations, psychotherapy add-on codes, and outpatient E/M
- Experience billing across multiple care settings, such as inpatient, skilled nursing, intensive outpatient, and outpatient
Schedule
- Full-time position
- Must be available during U.S. Central Time business hours
- Final schedule will be determined based on practice needs
Work Arrangement
- Remote
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