Medical Billing Specialist

Join Consultex as a Senior Medical Billing Specialist & Account Manager

Consultex Practice Management is seeking a highly skilled Senior Medical Billing Specialist & Account Manager to lead our behavioral health billing operations and client account management. This remote role combines expert knowledge in medical billing with strategic account oversight, ensuring compliance, accuracy, and exceptional client service. As a Senior Medical Billing Specialist & Account Manager, you will streamline revenue cycle processes, resolve complex claim issues, and serve as the primary liaison for behavioral health providers and clients, driving operational excellence and client satisfaction.

Key Responsibilities

Medical Billing & Revenue Cycle Management

• Full Cycle Billing: Oversee end-to-end billing operations, including claim submission, payment posting, and resolution of billing discrepancies.

• Retroactive Authorizations: Manage retroactive authorizations and reprocess claims accurately according to payer guidelines.

• Compliance & Audits: Ensure adherence to HIPAA, payer regulations, and internal policies; prepare for and respond to audits.

• Data Analysis: Monitor billing performance metrics, identify trends, and implement process improvements to maximize revenue recovery.

Client Account Management

• Relationship Management: Serve as the main point of contact for behavioral health providers and clients, addressing inquiries and resolving issues efficiently.

• Strategic Collaboration: Partner with internal teams (clinical, IT, compliance) to streamline communication and resolve billing challenges.

• Training & Mentorship: Guide and mentor junior staff, sharing best practices in billing operations and account management.

• Problem Resolution: Address escalated issues promptly, ensuring timely resolution of claim denials, disputes, and client concerns.

Required Qualifications

• Experience: 5–7 years in medical billing within healthcare, preferably in behavioral health, with proven account management experience.

• Education: Bachelor’s degree in Healthcare Administration, Business, Finance, or related field preferred; equivalent work experience considered.

• Technical Proficiency: Expertise in medical billing software, EHR systems, and Microsoft Office; knowledge of behavioral health platforms a plus.

• Regulatory Knowledge: Strong understanding of payer guidelines, retroactive authorization processes, HIPAA, and healthcare regulations.

• Analytical Skills: Ability to analyze billing data, identify trends, and implement solutions to enhance revenue cycle performance.

• Communication & Organization: Excellent written/verbal communication, detail-oriented, and capable of managing multiple priorities in a fast-paced environment.