Behavioral Health - SUD Medical Billing Specialist

Full Time l EST
Behavioral Health/ SUD billing experience is a must!

Key Responsibilities
Insurance Verification & Eligibility

• Verify patient insurance eligibility and behavioral health/SUD benefits.
• Confirm coverage, benefits, payer requirements, and authorization requirements.
• Identify potential insurance issues before services are billed.

Authorization & Renewals

• Process and track prior authorizations for behavioral health and SUD services.
• Monitor authorization numbers, approved units, service dates, and expiration dates.
• Coordinate authorization renewals and additional units as needed.
• Follow up with payers regarding pending or incomplete authorizations.

Claims Submission

• Prepare and submit accurate claims for behavioral health and SUD services.
• Ensure claims contain accurate patient, provider, diagnosis, CPT/HCPCS, modifier,

authorization, and payer information.

• Monitor claim status and follow up on rejected or unpaid claims.

Maryland Medicaid Billing

• Process claims for Maryland Medicaid.
• Understand Maryland Medicaid billing requirements and payer-specific procedures.
• Research and resolve Maryland Medicaid claim issues, rejections, and denials.

Denial Management

• Review denied and rejected claims to determine the root cause.
• Correct errors and resubmit claims when appropriate.
• Assist with reconsiderations and appeals.
• Identify recurring denial trends and proactively recommend solutions.

Accounts Receivable

• Monitor outstanding insurance claims and balances.
• Conduct timely A/R follow-up with insurance companies.
• Research aging claims, underpayments, and unpaid balances.
• Maintain accurate documentation of payer communications and follow-up activities.

Billing System Management

• Maintain accurate billing information within CollabMD.
• Ensure patient, payer, authorization, and claim information is accurately documented.
• Maintain organized records and billing workflows.

Required Qualifications

• 2+ years of hands-on medical billing experience
• Behavioral Health and/or SUD billing experience – required
• Maryland Medicaid billing experience – required
• CollabMD experience – required or strongly preferred
• Experience with insurance verification and eligibility
• Prior authorization experience
• Claims submission and follow-up experience
• Denial management and appeals experience
• A/R and insurance collections experience
• Strong understanding of U.S. healthcare insurance processes
• Excellent attention to detail and follow-through
• Ability to work independently and manage multiple priorities
• Strong written and verbal communication skills
• Ability to work U.S. Eastern Time hours

Non-Negotiables
The ideal candidate must have:

• Behavioral Health / SUD medical billing experience
• Maryland Medicaid billing experience
• Hands-on experience with CollabMD
• Strong claims, denial, and A/R experience
• Prior authorization and renewal experience
• Experience working with U.S. healthcare payers