Billing Specialist

CARE of Southeastern Michigan•Roseville, MI

10d•$20•Onsite

About The Position

The ideal candidate is detail‑oriented and knowledgeable of Behavioral Heath and Substance Use Disorder billing. This role is responsible for accurately processing medical claims, managing reimbursement activities, and ensuring compliance with state and federal regulations. The ideal candidate has strong analytical skills, a solid understanding of Michigan payer requirements, and experience working with healthcare billing systems. The ideal candidate is outgoing, able to work independently, as well as in a team environment.

Requirements

Ability to work independently as well as in a team environment.
Must possess knowledge and understanding of Recovery Oriented System of Care, and Trauma Informed Services.
High School/GED required.
1–2 years of medical billing or revenue cycle experience.
Knowledge of CPT, ICD‑10, and HCPCS coding.
Familiarity with Michigan Medicaid and major commercial payers (e.g., Blue Cross Blue Shield of Michigan, Priority Health, Meridian).
Proficiency with medical billing software and electronic health record (EHR) systems. Current System is ecr and PCE based Software.
Strong attention to detail and problem‑solving skills.

Responsibilities

Prepare, review, and submit medical claims to insurance companies, Medicare, Medicaid, and Michigan‑based payers.
Verify accuracy of CPT, ICD‑10, and HCPCS codes prior to claim submission.
Monitor claim status, follow up on unpaid claims, and resolve denials or rejections.
Process electronic and paper claims in accordance with Michigan Medicaid and commercial payer guidelines.
Generate patient statements and assist with billing inquiries.
Review patient accounts for accuracy and completeness.
Coordinate payment plans and communicate balances in a clear, professional manner.
Maintain compliance with HIPAA, CMS regulations, and Michigan-specific billing rules.
Ensure proper documentation is collected and maintained for audits and reimbursement.
Stay updated on changes in insurance policies, coding standards, and state regulations.
Work closely with providers, coders, and administrative staff to resolve billing discrepancies.
Communicate with insurance representatives to clarify coverage, benefits, and claim issues.
Support the revenue cycle team with reporting and process improvements.