Billing Specialist

Veterans • Shrewsbury, MA

8d • Onsite

About The Position

Veterans Inc. is seeking a high-energy, detail-oriented Behavioral Health Billing Specialist to join our finance team. In this critical role, you will secure the funding that makes life-saving care possible by navigating complex payer systems, resolving claim denials, and ensuring compliance. You are the vital link that bridges financial sustainability with compassionate, uninterrupted care for our veterans. We are seeking a dedicated Billing Specialist who will lead advanced pre-billing and billing operations for our Behavioral Health and Substance Use Disorder (SUD) programs. The role will serve as the team's subject matter expert on payer compliance, insurance verification, authorization management, and denial prevention. Working directly alongside the Billing Manager, will provide critical daily operational support to maximize financial sustainability. You will also collaborate closely with admissions, clinical staff, utilization review, and our external billing contractor to ensure every service is properly documented, authorized, and cleared for seamless reimbursement.

Requirements

• Associate degree in Healthcare Administration, Business Administration, Accounting, Finance, or related field preferred. Equivalent work experience may be substituted for formal education.
• Minimum of five (5) years of healthcare billing experience.
• Minimum of three (3) years of experience in insurance verification, authorizations, billing support, claims preparation, or payer relations.
• Experience in Behavioral Health and/or Substance Use Disorder services strongly preferred.
• Experience working with MassHealth, Medicare, Medicaid Managed Care Organizations, and commercial insurance plans.
• Must be able to successfully pass a CORI/Background records check.
• Compliance with Veterans Inc. COVID-19 Vaccination Policy. Religious and Medical Exemptions are considered.

Responsibilities

• Verify coverage: Confirm insurance eligibility, benefits, and payer-specific requirements for all new admissions and existing clients.
• Update systems: Maintain precise insurance records within the EHR and communicate coverage limitations or authorization needs to staff.
• Secure approvals: Obtain, track, and maintain authorizations for behavioral health and substance use disorder (SUD) services.
• Coordinate tracking: Manage expiration dates, submit Notices of Admission (NOAs), and collaborate with utilization review to prevent gaps in coverage.
• Audit accounts: Review documentation and authorizations prior to claim submission to prevent payment delays.
• Partner with contractors: Coordinate directly with the agency's external billing contractor to resolve edits, corrections, and claim issues.
• Stay compliant: Ensure all billing aligns with MassHealth, Medicare, Medicaid MCOs, commercial guidelines, BSAS, and HIPAA regulations.
• Act as an expert: Research payer updates and serve as the internal resource for evolving billing policies.
• Analyze trends: Identify systemic billing errors or authorization issues contributing to claim denials.
• Improve processes: Partner across admissions, clinical, and finance teams to implement process improvements that protect revenue.
• Lead the team: Act as a mentor to Billing Specialists, assist with onboarding, and develop workflow documentation.
• Support leadership by assisting the Billing Manager with audits, special projects, and departmental reporting.

Benefits

• BCBS Medical, Dental, and Vision Insurance
• $2500 Medical Opt-Out program if you have medical coverage through another source.
• Retirement Plan (403B) with a $2000 Match
• Flexible Spending Accounts
• Tuition Reimbursement Program
• Paid Parental Leave

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree