Billing Representative-Remote โ Austin
๐ 601 Old Oaks Ranch Road, Austin, TX 78676
Summary/Objective The Billing Representative is responsible for managing the revenue cycle process for residential treatment and detoxification services. This position requires expertise in behavioral health billing, claim submission, payment posting, denial management, and accounts receivable follow-up. The Billing Representative plays a critical role in ensuring accurate reimbursement, minimizing revenue leakage, and maintaining compliance with payer requirements and clinical documentation standards. The ideal candidate will possess a strong understanding of high-acuity behavioral health claims, revenue codes, and the documentation requirements associated with residential treatment center (RTC) and inpatient detoxification levels of care.
Required Schedule/Position Type Due to the nature of this role and the need for frequent interaction with insurance companies, employees are expected to work a schedule that closely aligns with standard insurance carrier business hours. Consistent availability during these hours is required to ensure timely claim processing, denial resolution, appeals management, and accounts receivable follow-up. Must be available to work on call rotation as scheduled including weekends and holidays. Any changes to the assigned schedule must be approved in advance by management. In addition, Nova Recovery Center reserves the right to change the required schedule with 14 daysโ notice subject to business needs.
Responsibilities
- Essential Functions
- Manage the full medical billing lifecycle for residential treatment and detoxification services.
- Review and scrub claims to ensure accuracy and compliance prior to submission.
- Submit electronic claims using 837I and 837P transaction formats.
- Monitor and resolve clearinghouse claim rejections.
- Post insurance payments and electronic remittance advice (835 ERA) transactions accurately and timely.
- Ensure claims are submitted in accordance with payer guidelines and required clinical documentation timelines.
- Maintain accurate billing records and support documentation.
- Denials & Appeals Management
- Audit denied claims to identify the cause of denial and determine corrective action.
- Interpret payer policies and reimbursement guidelines.
- Prepare and submit timely appeals for both technical and clinical denials.
- Gather and organize supporting documentation necessary for successful appeals.
- Track appeal outcomes and follow up with payers as needed.
- Implement strategies to reduce future denials and prevent revenue loss.
- Accounts Receivable Management
- Monitor outstanding accounts receivable balances.
- Follow up on unpaid or underpaid claims.
- Research reimbursement discrepancies and payment delays.
- Work to reduce aging accounts and improve overall collections performance.
- Maintain detailed documentation of collection activities and payer communications.
Qualifications
- Physical Residence in Texas, Arkansas or Ohio.
- Required Education & Experience
- Minimum of 2 to 4 years of dedicated medical billing and collections experience.
- Experience billing Residential Treatment Centers (RTC) and/or inpatient detoxification services required.
- Experience handling high-acuity behavioral health claims preferred.
- Knowledge & Skills
- Comprehensive understanding of Revenue Cycle Management (RCM).
- Knowledge of:
- Claim scrubbing
- Electronic claim submission (837I/837P)
- Clearinghouse rejection resolution
- Payment posting (835 ERA)
- Denial management
- Accounts receivable follow-up
- Proficiency with UB-04 claim forms.
- Knowledge of behavioral health revenue codes, including detoxification and residential treatment revenue codes (e.g., 0126โ1001).
- Strong understanding of payer policies and reimbursement guidelines.
- Ability to analyze denials and prepare effective appeals.
- Strong attention to detail and organizational skills.
- Excellent problem-solving and analytical abilities.
Benefits
- Full Time employees are eligible for Health, Dental, Vision and Life Insurance in accordance with Nova Policies. PTO begins to accrue at a rate of 5.85 hours per pay period after the probationary period.
Compensation
$18โ$22/hour