Accounts and Billing Specialist

Jewish Family Service•Buffalo, NY

5d•$29 - $31•Hybrid

About The Position

The Accounts and Billing Specialist is responsible for processing billing and helping clients understand their insurance coverage, account balances, and financial responsibilities. This role ensures the timely and accurate submission of claims while providing clear, compassionate communication to help clients understand their benefits, co-pays, deductibles, and any out-of-pocket costs. Key duties include preparing and submitting insurance claims, monitoring claim status, resolving claim denials and rejections, posting payments, reconciling accounts, explaining billing statements, setting up payment arrangements, resolving account discrepancies, and assisting clients with questions related to claims or outstanding balances. The position works closely with clinical, administrative, and revenue cycle staff to support accurate billing practices, maximize reimbursement, maintain regulatory compliance, and provide a positive client experience. A strong understanding of behavioral health and medical billing, CPT, and ICD-10 coding, payer requirements, and insurance regulations is essential to ensure accurate claim submission, compliance, timely reimbursement, and effective account resolution.

Requirements

Associates degree in Accounting, Business Administration, Healthcare Management, or a related field required.
Minimum of 2-3 years of experience in medical or behavioral health billing, patient accounts, or health revenue cycle management.
Excellent interpersonal, communication, and problem-solving skills.
Ability to work independently and handle confidential information with discretion.
Must have good typing, data entry and mathematical skills.
Exhibited ability to effectively work within an inclusive and culturally and linguistically diverse environment.
Strong computer skills, especially with electronic medical records, Outlook, Word, Excel, PowerPoint, and web-based health information systems.

Nice To Haves

Bachelor's degree preferred.
Equivalent experience may be considered in lieu of formal education.
Certified Professional Coder certification is strongly preferred.
Experience with Medent strongly preferred.

Responsibilities

Process and submit professional and institutional insurance claims accurately and timely in accordance with payer requirements and agency policies.
Review billing documentation for completeness and accuracy prior to claim submission, ensuring appropriate CPT, ICD-10, modifiers, and other required billing elements are included.
Monitor claim status, identify claim rejections or denials, and take appropriate corrective action to ensure timely reimbursement.
Post insurance and client payments accurately and reconcile payment activity within the electronic health record and billing systems.
Work with the Medent electronic medical record (EMR) system to troubleshoot billing, claim submission, and system configuration issues, collaborating with internal staff and Medent support to resolve problems and optimize billing workflows.
Prepare and submit corrected claims, claim reconsiderations, and appeals as appropriate.
Verify client insurance eligibility and benefits prior to billing and identify coverage issues that may impact reimbursement.
Serve as the primary point of contact for clients regarding billing inquiries, insurance coverage, and account balances.
Communicate clearly and compassionately with clients to explain benefits, co-pays, deductibles, and out-of-pocket expenses.
Review and interpret Explanation of Benefits (EOBs) to help clients understand payment and denial information.
Establish and manage payment arrangements, following agency policies and financial guidelines.
Investigate and resolve account discrepancies, billing errors, or denied claims in a timely manner.
Notify clients of overpayments and coordinate with the Finance team to ensure refunds are processed within 60 days in accordance with regulatory requirements.
Collaborate with clinical and administrative staff to verify client insurance coverage, obtain missing documentation, and ensure accurate and compliant claim submission.
Maintain detailed and confidential client account records in compliance with HIPAA and agency standards.
Maintain up-to-date knowledge of behavioral health billing regulations, payer policies, coding guidelines, and reimbursement updates.
Monitor outstanding accounts receivable and follow up with payers and clients as needed to ensure timely payment and resolution of outstanding balances.
Collaborate with providers, front office staff, Finance, and other departments to resolve billing discrepancies and improve revenue cycle processes.
Assist in preparing and distributing client statements and respond to billing inquiries in a timely and professional manner.
Support month-end and year-end billing reconciliation activities, audits, and reporting as requested.
Support a positive client experience by providing responsive, respectful, and solution-oriented customer service.
Attend agency and department in-service trainings, staff meetings, and other agency-related activities as required.