Billing and Medical Claims Processor Bosque Mental Health Associates, Inc. Albuquerque, NM Job Details Part-time $20 - $23 an hour 16 hours ago Benefits Paid holidays Paid time off Qualifications Customer communication Teamwork Medicare HIPAA Attention to detail Documentation review Full Job Description Position Summary The Billing and Medical Claims Processor manages agency's revenue cycle, insurance billing, patient accounts, financial reporting, and daily administrative operations. This position works closely with therapists, patients, insurance companies, and leadership to ensure timely reimbursement, regulatory compliance, and efficient office operations. The Perks Bosque Mental Health is an award-winning organization known for its exceptional team of seasoned, professional colleagues. The environment is comfortable, hard-working and easy-going. We provide on-going training, Aflac Accidental Insurance coverage, and paid holidays. We are located in a beautiful building with a spa-like environment that inspires health and healing. You will be part of a team that values and relies upon your expertise, personal integrity and precision with numbers. Pay rates are commensurate with education and experience.

Part-time:

30 hours per week This is an in-person position. Primary ResponsibilitiesBilling & Revenue Cycle

• Submit and monitor insurance claims.
• Daily collection of copays, deductibles, and coinsurance.
• Resolve denied, rejected, and incomplete claims.
• Process charges for no-shows, late cancellations, medical records, and other billable services.
• Post insurance and client payments.
• Balance electronic deposits and payment transfers.
• Process refunds and prepare client statements.
• Monitor outstanding balances and collections.
• Generate daily, weekly and monthly financial reports, including aging reports.
• Manage client accounts with collection agency. Insurance Administration
• Verify and update client insurance information.
• Work with insurance companies to resolve billing questions and reimbursement issues.
• Verify documentation, coding, dates of service, and billing accuracy.
• Ensure accurate coordination of benefits.
• Verify client insurance eligibility. Client Support
• Respond to client billing questions.
• Communicate billing concerns on client accounts to therapists.
• Contact clients regarding insurance issues or terminated coverage. Therapist Support
• Prepare weekly therapist payroll reports.
• Monitor completion of therapy clinical notes for billing.
• Assist therapists with billing and reimbursement questions.
• Communicate payroll and employment changes to accounting.
• Present at monthly on-line, staff-wide meetings as needed. Compliance
• Maintain current knowledge of billing regulations and payer requirements.
• Ensure agency-wide HIPAA compliance.
• Communicate billing and regulatory updates to staff.
• Maintain CPT and ICD coding knowledge.
• Coordinate annual HIPAA education for staff. Office Administration
• Maintain operational reports, dashboards, and KPI tracking.
• Upload insurance documents into the electronic health record.
• Troubleshoot billing system issues.
• Attend weekly management meeting.
• Regular communication with leadership on all financial matters. Qualifications
• Experience in medical billing, preferably behavioral health, and a desire to work with an outpatient, behavioral health population.
• Certified Professional Biller (CPB), Certified Medical Reimbursement Specialist (CMRS), or similar certification.
• Knowledge of insurance billing, Medicare, Medicaid, and commercial payers.
• Familiarity with electronic health records and billing software. InSync/Qualifacts knowledge preferred.
• Understanding of HIPAA
• Understanding of CPT and ICD coding for mental health.
• Experience with insurance claims denial management to resolution and payment reconciliation.
• Strong organizational, communication, and customer service skills.
• Ability to manage multiple priorities while maintaining accuracy and confidentiality.
• Familiarity with managed care contracts and fee schedules. Core Competencies
• Revenue Cycle Management
• Insurance & Claims Processing
• Financial Reporting
• Customer Service
• Regulatory Compliance
• Problem Solving
• Organization & Time Management
• Team Collaboration
• Attention to Detail
• Confidentiality & Professionalism
• Efficient self-management, personal integrity and trustworthiness

Pay:

$20.00 - $23.00 per hour

Benefits:

Paid time off Application Question(s): What is your experience level with managing claim denials and appeals? Are you familiar with HIPAA compliance regulations regarding client data and medical billing?

Experience:

processing medical claims or handling healthcare bill: 2 years (Required)

License/Certification:

Medical Billing or Coding certification or the like? (Required) Ability to

Commute:

Albuquerque, NM 87110 (Required)

Work Location:

In person