Medical Claims Processor

Medical Claims Processor Turning Point Recovery Center of New Mexico - 3.4 Albuquerque, NM Job Details Full-time 13 hours ago Benefits Health insurance Dental insurance Paid time off Employee assistance program Vision insurance 401(k) matching Qualifications Teamwork Medicare Commercial insurance knowledge Patient management software Medicaid health insurance Bachelor's degree Medicare regulations Electronic health record (EHR) management for billing and coding Attention to detail Data entry Centers for Medicare & Medicaid Services (CMS) billing regulations Medicaid regulations Medicaid Business Administration Full Job Description Behavioral Health Claims Processor Wanted at Turning Point At Turning Point, we're looking for a detail-oriented and analytical Behavioral Health Claims Processor to join our team. As New Mexico's leader in evidence-based addiction treatment, we rely on accurate and timely billing to ensure our clients continue receiving the care they deserve. This position plays a critical role in the financial health of our organization by managing behavioral health claims, resolving billing issues, and maximizing reimbursement for services provided. If you enjoy problem-solving, working with healthcare data, and ensuring accuracy in every detail, we'd love to hear from you. Key Responsibilities Your role will be to ensure timely and accurate billing while supporting the organization's revenue cycle.

Responsibilities include:

Reviewing and verifying the accuracy of behavioral health claims prior to submission Processing claims for urine drug screens, Peer Support services, and other treatment programs Maintaining billing spreadsheets and reports to support financial tracking and reconciliation Utilizing electronic clearinghouse systems to submit claims, monitor rejections, identify trends, and resolve denials Working with insurance companies, including Medicare, Medicaid, commercial insurers, and Blue Cross Blue Shield, to resolve billing questions and reimbursement issues Verifying documentation, coding, dates of service, and billing accuracy Collaborating with clinical, administrative, and billing staff to improve revenue cycle efficiency Maintaining compliance with payer requirements, billing regulations, and organizational policies Staying current on healthcare billing regulations, coding updates, and reimbursement practices What You Bring Minimum of two years of experience in medical billing, healthcare revenue cycle management, or a related field Experience working with Electronic Health Record (EHR) systems and medical billing software Working knowledge of ICD-10, CPT, and HCPCS coding systems Understanding of Medicare, Medicaid, commercial insurance, and behavioral health reimbursement processes Strong analytical, organizational, and problem-solving skills Excellent attention to detail and accuracy Ability to manage multiple priorities while meeting deadlines Strong written and verbal communication skills Preferred Qualifications Bachelor's degree in Accounting, Finance, Healthcare Administration, Business Administration, or a related field Certified Professional Biller (CPB), Certified Medical Reimbursement Specialist (CMRS), or similar certification Experience in behavioral health or substance use disorder billing Experience with insurance denial management and payment reconciliation Advanced proficiency with Microsoft Excel and reporting tools Familiarity with managed care contracts and fee schedules The Perks At Turning Point, you'll become part of a mission-driven organization dedicated to helping individuals achieve lasting recovery. You'll work alongside a collaborative team while supporting the financial operations that allow our clinical programs to thrive. Your work will directly contribute to ensuring our clients continue receiving high-quality, evidence-based care. Working Environment This position is primarily office-based and requires extended periods of computer work, data entry, and interaction with electronic billing systems. The ideal candidate is highly organized, able to manage multiple priorities, and comfortable working both independently and collaboratively in a fast-paced healthcare environment. Reasonable accommodations will be provided to qualified individuals with disabilities in accordance with applicable law.

Benefits:

401(k) matching Dental insurance Employee assistance program Health insurance Paid time off Vision insurance

Work Location:

In person