Billing Specialist

• Collaborate with advisors to maximize client invoice amounts
• Work efficiently to complete client billing
• Effectively manage Work In Process (WIP)
• Prepare billing detail and WIP analysis for review with billers
• Generate workflow reports to identify completed jobs for billing analysis
• Prepare and approve invoices for delivery to clients
• Communicate with advisors, Regional Managing Principals, and Administrative Services team to ensure timely billing
• Discuss proposed billing amounts with advisors to increase billing amounts appropriately
• Discover additional work completed beyond scope and bring it to the advisor’s attention
• Understand industry terminology to accurately identify and describe services provided
• Collaborate with advisors to increase billing performance metrics
• Demonstrate exceptional time management skills using Outlook calendar to manage the billing process

Regional Billing Specialist

• Manage and maintain provider schedules and virtual appointment templates.
• Monitor and update internal systems, documentation, and digital workflows to ensure operational accuracy.
• Coordinate onboarding logistics for new staff, including system access, credentialing documentation collection, and internal setup tasks.
• Track and follow up on administrative deadlines, credentialing timelines, vendor tasks, and recurring operational processes.
• Ensure all incoming work is processed within specified SLAs and follows Sanusom’s workflow including entry into all shared trackers in Teams, EHR, Sanusom Portal, CallShaper, etc.
• Perform insurance eligibility checks and verify patient coverage using payer portals or clearinghouses.
• Accurately input and update patient insurance and demographic information in the shared trackers, EHR, Sanusom Portal, etc.
• Prepare daily/weekly/monthly billing batches and ensure accurate coding and charge capture data is passed to billing partners or internal billers.
• Assist in monitoring denied claims or rejections by coordinating with billing vendors or RCM teams for follow-up.
• Maintain payer records and documentation needed for audits or payer communication.
• Manage user permissions and internal system configurations across clinic tools (EHR, scheduling, telehealth platforms, etc.).
• Support platform troubleshooting and coordinate with internal/external tech support for escalations.
• Document internal SOPs and operational protocols; ensure consistency across workflows.
• Act as an internal point of contact for operational questions from clinical or administrative staff.
• Support preparation for internal team meetings, generate reports, and track action items or KPIs as assigned.
• Coordinate recurring administrative functions (e.g., provider onboarding trackers, insurance renewals, system audits).

• Support patients with payment processing, billing education, insurance verification, and claims-related inquiries.
• Deliver empathetic, accurate, and compliant service while navigating healthcare billing systems and policies.
• Perform all payment processing and payment plan functions in addition to advanced billing, insurance, and claims support.

Patient Billing Representative

• Lead the execution of comprehensive billing cycles for high-net-worth and multi-entity RIA/TAMP portfolios, ensuring absolute accuracy and regulatory compliance.
• Serve as the internal Orion power-user; architecting complex fee structures, automating tiered billing schedules, and optimizing platform configurations to support firm growth.
• Design and implement rigorous data integrity frameworks and "zero-defect" reconciliation processes to catch anomalies across platforms.
• Lead the billing onboarding for large-scale firm migrations, translating intricate advisory agreements into functional billing logic.
• Continuously evaluate our tech stack (Orion, CRMs, and Reporting tools) to streamline workflows, reduce manual intervention, and increase departmental throughput.
• Act as the primary point of escalation for complex billing discrepancies, providing professional, high-touch support to financial advisors.
• Partner with Finance, Compliance, and Operations leadership to align billing practices with industry regulations (SEC/FINRA) and internal revenue goals.

• Provide exemplary customer service.
• Works daily electronic billing system (Cerner & nThrive) and submits insurance claims to third-party payers; reviews daily claim edits from the hospital billing system and makes necessary corrections to allow electronic submission.
• Assessing and analyzing claim edits daily within the billing system leading to a resolution within 24-48 hours.
• Maintains a thorough understanding of federal and state regulations as well as requirements specific to Medicare, Medicaid, and fiscal intermediaries in order to promote compliant claims submission practices for governmental claims.
• Communicates any edits that may need joint resolution with external departments.
• Prepares and submits manual insurance claims to third-party payers who do not accept electronic claims or who require special handling.
• Resubmission of claims that may need corrections.
• Verify that claims have been received by the appropriate payer.
• Investigate and resolve any issues in regards to claim transmission.
• Mail/Fax/Email paper claims to the appropriate payer the day they are generated.
• Performs effective, timely and efficient follow-up on all outstanding debit and credit balances within the expected time period.
• Review and analyze outstanding debit and credit balances to determine appropriate follow-up.
• Contributes innovatively to the success of our department and is compliant in all patient and billing aspects.
• Maintains a base-line understanding of federal and state regulations, as well as specific payer requirements and explanation of benefits to ensure compliance.
• Effectively handles communications, including email, telephone and instant message, from payers and departments within and outside of the department.
• Understands and maintains compliance with HIPAA guidelines when handling patient information.
• Reviews, processes, and resolves all incoming patient and insurance correspondence within one business day.
• Reviews and prepares responses to correspondence from patients and insurance carriers within a reasonable time frame.
• Responds to formal communication, both external and internal, within a reasonable time frame.
• Documents all activity taken within an encounter in the billing system.
• Clear and concise messaging.
• Responsible for making and documenting timely phone calls to insurance in regards to billing matters within the billing system.
• Provides updates to existing policies and procedures as needed and proposes new.
• Communicates with staff routinely and effectively using all forms of communication.
• Builds relationships and fosters positive communication with applicable departments outside of PFS.
• Documents all activity - each time an account is touched - in the notes section of the AR Host I.S. System, at the account level, appropriately, timely, compliantly and thoroughly.
• Stays current on healthcare regulations.
• Attends training sessions, internal and external.
• Performs other related duties as assigned.

Insurance Billing Specialist, Full Time

• Responsible for billing Medicaid, Medicare, and Commercial Insurance for behavioral health services
• Develop procedures and provide supervision, direction, and oversight for the billing, coding, and provider paneling functions
• Work 40 hours a week, Monday through Friday, 8:00 am to 5:00 pm
• Participate in some in-person meetings within Kent County

Behavioral Health Billing Supervisor

• Own the full revenue cycle from intake to payment
• Monitor claims, A/R, and reimbursement performance
• Ensure accurate coding for sleep studies and related services
• Manage insurance claims, denials, and prior authorizations
• Lead and develop billing staff
• Maintain compliance with HIPAA and billing regulations
• Track key metrics and drive process improvements

Billing Manager

• Responsible for the timely review and submission of medical claims to insurance companies from a wide variety of providers and clinics
• Knowledgeable of all aspects of the financial process from scheduling, billing, and collections
• Review patient bills for accuracy and completeness in a timely manner
• Take the initiative to obtain missing information to ensure claims are submitted accurately and timely
• Knowledge of insurance rules and guidelines; such as, Medicare and Medicaid
• Adhere to billing guidelines, policies, and procedures
• Identify the proper party to be billed; such as, insurance company or patient
• Complete the entire required billing checklists prior to submission
• Perform follow up activities to ensure documentation is gathered in a timely manner
• Communicate with clinic personnel and insurance companies
• Ensure necessary documentation is included or coordinate with appropriate clinic to update records

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