Medical Billing Specialist – Lead

Job not on LinkedIn

🔥 8 hours ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $25 - $38 / hour

⏰ Full Time

🟠 Senior

🏥 Medical Billing and Coding

👻 Ghost score 0%

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Counseling Works

WebsiteLinkedInAll Job Openings

11 - 50 employees

🏥 Healthcare

🧘 Wellness

Healthcare • Wellness

Counseling Works is a mental health and therapy practice offering outpatient counseling services to individuals, couples, families, adolescents, and specialized populations (LGBTQIA+, first responders, perinatal clients). They provide treatment for anxiety, depression, trauma/PTSD, substance abuse, eating disorders, relationship issues, and wellness-focused services (women's and men's wellness), using in-person and telehealth modalities and multiple Illinois locations. The practice emphasizes clinician matching, insurance acceptance, a structured intake/client journey, and a team of licensed therapists and support staff.

📋 Description

• Manage the full billing cycle in TherapyNotes, including charge entry, claim scrubbing, batch submission, resubmission, and claim holds • Process ERAs and EOBs; post insurance payments, adjustments, and denials; reconcile against deposits • Manage payer and code configuration in the practice management system • Manage insurance accounts receivable, aging review, and unpaid or underpaid claims • Research and resolve denials; file and track appeals through resolution • Identify recurring denial causes and recommend preventive process changes • Review CPT and ICD-10 coding for outpatient behavioral health claims • Apply and verify modifiers, place-of-service codes, and telehealth coding • Work with clinicians and client care to correct coding issues at the source • Maintain current knowledge of coding updates and payer policy changes • Assist with provider credentialing and re-credentialing; maintain files and deadlines • Complete and maintain CAQH profiles • Submit and track commercial payer applications; assist with payer enrollment and contracting • Maintain records of licenses, certifications, malpractice insurance, NPI information, and credentialing documentation • Act as a billing point of contact for clients, clinicians, client care, and the admin team • Report assigned scorecard measures and document owned workflows; cross-train teammates • Maintain strict confidentiality of protected health information and HIPAA compliance • At Lead level: own credentialing and payer enrollment, supervise billing staff, coordinate workflows, own department scorecard, manage payer relationships, conduct denial root-cause analysis, enforce SOPs, and support onboarding/cross-training

🎯 Requirements

• EHR fluency; TherapyNotes experience strongly preferred • Strong working knowledge of CPT and ICD-10 coding • Working knowledge of HMO/PPO, Medicare, Medicare Advantage, Medicaid managed care, and commercial payer requirements • Demonstrated ability to work ERAs, denials, and appeals independently, without day-to-day direction • Advanced organizational skills; able to prioritize and hold multiple deadlines without being reminded • Proficiency with Excel and Google Workspace (Gmail, Docs, Sheets, Forms) • Working knowledge of the mental health field, PHI confidentiality, and HIPAA compliance • Prior experience in a patient- or client-facing support role • Resourceful, self-directed, a proactive communicator, and team-oriented • Warm, empathetic, positive, thoughtful, and friendly demeanor • Passion for supporting mental health and the community • Billing Specialist: 3+ years of medical billing and collections experience; credentialing experience strongly preferred and willingness to learn it required • Billing Lead: 5+ years of medical billing and collections experience, including hands-on credentialing and experience directing the day-to-day activities of a billing team or function • Hands-on provider credentialing experience, including CAQH profile management and commercial payer applications — required at the Lead level • Behavioral health or multi-site group practice billing experience preferred • Experience with supervisory billing arrangements for pre-licensure clinicians preferred • Experience managing Blue Cross Blue Shield of Illinois enrollments and escalations preferred • Medicare enrollment and PECOS experience preferred • Experience reporting departmental metrics to leadership preferred • Certified Medical Biller — CPB, CMRS, or equivalent (required at the Lead level, strongly preferred at the Specialist level) • Coding certification — CPC, CCS, or equivalent preferred • Credentialing certification — CPCS or equivalent preferred • Minimum of a high school diploma or equivalent • Associate’s degree in healthcare, business, office administration, or a related field preferred • Ability to work 30 hours per week within Monday–Friday Central Standard Time business hours

🏖️ Benefits

• Health, dental, and vision insurance • Life insurance and disability plans covered 100% by employer • 401k with employer matching • PTO, vacation & sick time • Flexible schedule • Fully remote work