Behavioral Health Biller

Family Access Center•Sioux City, IA

83d•Onsite

About The Position

Family Access Center is hiring a Behavioral Health Biller to join our team, supporting and empowering individuals to overcome life's challenges by providing quality services in our Sioux City office.

Requirements

2+ years of dedicated medical billing experience, with a strict preference for mental/behavioral health billing.
Proficiency utilizing Electronic Health Record (EHR) systems and billing clearinghouses (e.g., SimplePractice, TherapyNotes, Kareo, Waystar, Availity).
Strong familiarity with mental health CPT billing codes, modifiers, DSM-5/ICD-10 crosswalks, and timely filing limits.
High proficiency in reading and interpreting complex Explanation of Benefits (EOBs) and Electronic Remittance Advices (ERAs).
Strong verbal and written communication skills for negotiating with insurance representatives and speaking empathetically with patients.

Nice To Haves

Certified Medical Coder (CMC) or Certified Professional Biller (CPB) designation is a plus.

Responsibilities

Review, troubleshoot, and correct rejected, denied, or unpaid insurance claims via the clearinghouse or insurance portals.
Investigate the root causes of claim denials (e.g., prior authorization issues, coordination of benefits, coding errors) and submit formal appeals with necessary medical documentation.
Accurately post insurance payments (ERAs/EOBs) and patient payments to patient accounts, identifying any underpayments or processing errors.
Prepare, review, and electronically submit daily clean claims for commercial insurance, Medicaid, Medicare, and managed care organizations (MCOs).
Verify that clinicians have documented correct ICD-10 diagnostic codes and mental health CPT codes (e.g., 90834, 90837, 90791) along with appropriate modifiers (e.g., 95 for telehealth).
Confirm client insurance eligibility, mental health benefits, copays, deductibles, and track required prior authorizations.
Monitor the aging A/R report to actively follow up on outstanding claims over 30, 60, and 90 days old.
Answer client inquiries regarding statements, deductibles, coverage discrepancies, and coordinate payment plans.
Communicate regularly with clinical staff to resolve missing documentation, signature requirements, or recurring coding errors.