Medical Billing Specialist II

Description

Medical Billing Specialist II

Full-Time, On-Site

Hiring Range: $24.94 – $30.55 per hour

Benefits at a Glance 

• Comprehensive Coverage: Health, Dental & Vision 
• Generous PTO: Up to 19 days + 2 mental health days + 10 holidays (pro-rated for part-time)
• Fully Paid YMCA Membership for you and eligible family members
• Company-Paid Life & Disability Insurance 
• Student Loan Assistance & Professional Development 
• 403(b) Retirement Plan with Company Contributions 
• Employee Assistance Program (EAP) 
• Pet Insurance 
• Free Wellness App (2MorrowHealth) 
• Collaborative, Supportive Team Environment 

Under the direction of the Manager of the Billing Team, the Medical Billing Specialist II performs advanced behavioral health billing and accounts receivable functions involving moderate to high-complexity and high-dollar claims. This role is responsible for managing denials, collections, payment variances, and Special Accounts, ensuring accurate billing practices and timely reimbursement across all payer types.

The Medical Billing Specialist II works independently, applying in-depth knowledge of payer requirements, billing regulations, and revenue cycle workflows. The position collaborates with internal teams and external payers to resolve complex billing issues, support financial performance, and promote process improvements.

Primary Responsibilities:

• Manage the end-to-end billing lifecycle for assigned high-dollar, complex, and Special Accounts, from claim submission through final resolution.
• Monitor and resolve claim denials and underpayments, including analysis of trends and identification of corrective actions.
• Perform advanced collection activities to support timely reimbursement from commercial, Medicaid, Medicare, and private pay sources.
• Oversee payment processing activities by reviewing and reconciling payments, identifying discrepancies, and supporting resolution of payment variances.
• Serve as a point of contact for complex billing matters, working collaboratively with internal departments, providers, patients, and payer representatives.
• Ensure accurate and timely documentation of account activity within billing and revenue cycle systems.
• Monitor accounts receivable aging and take appropriate action to reduce outstanding balances and financial risk.
• Support denial management and accounts receivable reporting by providing data, insight, and feedback as requested.
• Identify opportunities for process improvement and provide recommendations to leadership to enhance efficiency, accuracy, and reimbursement outcomes.
• Participate in departmental meetings and contribute to team collaboration and knowledge sharing.
• Maintain compliance with all applicable state, federal, and payer regulations, policies, and standards.
• Utilize billing systems, payer portals, and government billing platforms to manage claims and reimbursement activity.
• Maintain productivity and quality standards consistent with departmental expectations.
• Support the Billing Assistant with eligibility verification.
• Perform other related duties as assigned in support of revenue cycle goals.

In addition to the above, any other responsibilities appropriate to the position and not specifically listed in the job description. 

Supervisory Responsibilities: None  

Minimum Qualifications

EDUCATION: High School Diploma or GED

EXPERIENCE: Experienced—minimum of three (3) years of progressively responsible experiencein medical billing, accounts receivable, or revenue cycle operations. 

Preferred Qualifications:

EDUCATION: Bachelor’s degree in accounting, business administration, healthcare administration, or a related field.

EXPERIENCE:

• Four (4) or more years of experience in medical and/or behavioral health billing
• Experience in behavioral health, psychiatric, or specialty medical billing environments.
• Prior experience working with Electronic Health Record (EHR) and practice management systems.
• Coursework or formal training in medical and/or psychiatric terminology.

LICENSE/CREDENTIALS: Professional certification such as Certified Professional Coder (CPC).  

Our recruitment processes are designed to prevent discrimination against our people regardless of gender identity or orientation, religion, ethnicity, age, neurodiversity, disability status, citizenship, or any aspect which makes someone unique.