Edgecare360 LLC Billing Specialist - Contractor Remote · Part time

Remote - Billing Specialist needed for Small Behavioral Health Agency



  • The Billing Specialist will be responsible for working with Utilization manager, helping to gather required documentation from clinicians and submitting for prior authorizations
  • Identify and bill secondary or tertiary insurances
  • Billing to include claims submissions, clearinghouse, posting payments, patient balances, and denial management in the Electronic health records (EHR) system i.e.. Therapy Notes
  •  Monitor the billing department, and is required to be self motivated
  • Must have experience with GAMMIS, and Medicare, Amerigroup, Caresource, peachstate, BCBS and other payer sites (palmetto, Availity) are plus
  • Understand methods of submitting authorizations, checking status, submitting reconsiderations, etc.
  • Investigate /appeal claims/open accounts receivables (denials and delinquent accounts) by actively calling payer organizations or utilizing web-based connectivity
  • Exceptional customer service skills
  • verify coverage and eligibility for mental health services
  •  collect unpaid claims and clear up discrepancies by telephone, fax and/or email communication
  •  complete data entry to update spreadsheets and any reports; 


  • High school graduates with experience, welcome to apply, Licensed clinicians preferred with minimum of 3 to 5 years in healthcare insurance accounts receivable
  • Stable, reliable internet with quiet working environment
  • Knowledge of CPT and ICD-10 coding and the use of modifiers is required.
  • Knowledge of GAMMIS, AVAILITY, Georgia Medicaid, Medicare and CMO knowledge required
  • Knowledge of HMO, PPO, managed care and indemnity plans is required.
  • Ability to efficiently multitask
  • Ability to triage priorities and express needs openly
  • Ability to work well as team member
  • Effective communication skills
  • Detail oriented


$18 - $20 per hour