Billing Associate - Mental Health Services

Job Summary

The Billing Associate/Specialist is responsible for the accurate and timely posting of payments, adjustments, and denials for mental health services billed to Medicaid, Medicare, and commercial insurance plans. This role requires advanced knowledge of payer reimbursement methodologies, contractual allowances, and behavioral health billing requirements. The position plays a key role in maintaining financial accuracy, overall workflow of billing, supporting follow-up activities, and optimizing revenue for services provided by psychiatrists and mental health counselors.

Key Responsibilities

• Accurately post insurance payments, patient payments, contractual adjustments, and refunds for Medicaid, Medicare, and commercial payers

• Review and interpret EOBs and ERAs, including complex payment scenarios such as multiple payers, secondary claims, and coordination of benefits

• Apply payer-specific reimbursement rules, fee schedules, and contractual adjustments

• Identify underpayments, overpayments, denials, and posting discrepancies and route accounts for appropriate follow-up or appeal

• Reconcile payments to daily deposits, lockbox reports, and remittance files to ensure financial accuracy

• Research and resolve complex payment variances and posting issues independently

• Maintain accurate patient account balances to support accounts receivable follow-up and financial reporting

• Collaborate closely with charge entry, coding, and follow-up teams to resolve billing and reimbursement issues

• Support month-end close, audits, and payer reconciliations

• Ensure compliance with payer contracts, CMS guidelines, Medicaid regulations, and internal policies

• Maintain strict confidentiality and compliance with HIPAA and mental health privacy requirements
• ​​​​​​Complete insurance verification as needed

• Serve as a resource and mentor other billing staff as needed

Qualifications

• High school diploma or equivalent required; associate or bachelor’s degree in healthcare administration, accounting, or related field preferred

• 3–5+ years of experience in medical billing or payment posting, with significant experience handling Medicaid, Medicare, and commercial plans

• Strong experience in behavioral health or mental health billing preferred

• Advanced knowledge of EOBs, ERAs, payer payment methodologies, and contractual adjustments

• Working knowledge of CPT, ICD-10, and common mental health billing codes and modifiers

• Experience with EHR and practice management/billing systems

• Excellent attention to detail and high level of accuracy

• Strong analytical and problem-solving skills

• Ability to manage complex, high-volume workloads with minimal supervision

• Strong written and verbal communication skills

Preferred Skills and Certifications

• Experience with secondary billing and coordination of benefits

• Familiarity with telehealth reimbursement rules and modifiers across payers

• Knowledge of state-specific Medicaid behavioral health billing requirements

• Certification such as CPC, CBCS, CPB, or similar preferred

• Proficiency in Microsoft Excel, including basic reporting and reconciliation functions

Work Environment

• Office-based

• Standard business hours; occasional deadlines tied to month-end close or audits

• Primarily computer-based

Physical Requirements

• Ability to sit for extended periods and perform detailed computer-based work

• Ability to review and analyze detailed financial and billing information on a computer screen