Billing & Insurance AR Collection Specialist with experience in Substance Use Disorder (SUD)

Calpion/Plutus Health - Dallas, TX

Full-time - Mid Level

Dallas, TX

About the position

The Billing & Insurance AR Collection Specialist at Plutus Health Inc. is responsible for managing accounts receivable tasks specifically related to Substance Use Disorder (SUD) billing. This role involves following up on claims, resolving outstanding balances, and ensuring timely reimbursement while maintaining compliance with relevant regulations and payer guidelines. The ideal candidate will possess strong communication skills and a deep understanding of the unique challenges associated with SUD billing.

Responsibilities

• Proactively follow up with insurance companies and other payers to ensure timely resolution of unpaid claims, focusing on SUD-related services.
• Analyze and address claim denials, rejections, and underpayments related to SUD treatments, ensuring accurate resubmission or appeal processes.
• Review and manage patient accounts, including verifying insurance coverage, calculating patient responsibility, and coordinating with patients for outstanding balances.
• Maintain detailed and accurate records of all follow-up activities, payer communications, and claim statuses in the billing system.
• Ensure all activities comply with relevant regulations, payer guidelines, and company policies, particularly those related to SUD services.
• Work closely with billing, coding, and clinical teams to resolve issues and improve the overall revenue cycle process for SUD services.
• Prepare and present regular reports on AR performance, including aging reports, denial trends, and recovery rates specific to SUD billing.

Requirements

• Minimum of 4-5 years of experience in AR calling, with a focus on Substance Use Disorder (SUD) billing and collections.
• Strong understanding of SUD treatment services, including relevant billing codes, payer requirements, and regulatory guidelines.
• Excellent communication skills, both verbal and written, with the ability to interact effectively with payers, patients, and internal teams.
• Proficient in using billing software, electronic health records (EHR), and Microsoft Office Suite, particularly Excel.
• Meticulous in reviewing claims, identifying discrepancies, and ensuring accurate resolution.
• Strong analytical skills to investigate and resolve complex AR issues related to SUD services.

Nice-to-haves

• Additional certification in medical billing or healthcare administration is preferred.

Benefits

• Health insurance
• Paid time off