Billing/Claims Specialist

Job Title: Billing/Claims Specialist   

Reports To: Billing & Collections Supervisor

Location: Remote, open to Hybrid if local to Boise 

Schedule: Monday-Friday 8am-5pm MST

Compensation: $24.50-$26.50/hour

Northpoint Recovery Holdings, LLC began 2009 as Ashwood Outpatient and officially launched the Northpoint platform in 2015. Now celebrating 10 years of growth in 2025, Northpoint is a leading behavioral healthcare provider offering evidence-based treatment for adults with substance use and co-occurring disorders through the Northpoint Recovery brand, and mental health treatment for adolescents through Imagine by Northpoint. Operating under an in-network, commercial insurance model, Northpoint has grown exclusively through de novo expansion—from two facilities to seventeen across the Western U.S.—with more planned in both existing and new markets. We’re guided by core values of humility, heart, inspiration, and conviction. Our mission is simple: saving lives and restoring relationships by helping people get their lives back, and treating every individual with empathy and respect.

POSITION SUMMARY: As a key member of the Revenue Cycle Management team, the Billing Specialist is responsible for electronic and paper claims submission, claim follow up, and claim resolutions, and ensuring all are processed accurately and timely, for payment posting from various insurance companies. The Billing Specialist will communicate and collaborate with insurance companies, RCM staff, and clinical teams on notes, records, and other information needed to ensure timely submission of claims. The ideal candidate will have a solid understanding of the entire billing life cycle of a patient, to include verifications, pre-authorization, utilization review, appeals, claims submission, claims adjudication, and denials. This person will understand and remain current on contract guidelines related to per diem and fee for service for proper billing to third-party payors. The ideal candidate will have strong knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems required.

ESSENTIAL RESPONSIBILITIES AND DUTIES INCLUDE:

• Batch and submit HCFA1500 and UB04 insurance claims electronically via billing platform and/or payer portal
• Ensure billing accuracy and efficiency, and resolve payer rejections/denials swiftly for services provided to Northpoint patients and clients
• Review information from electronic medical records in patient account (IE: auth, benefit verification, orders, notes, etc.) to ensure preparation and submission of clean claims
• Generate and submit claims to insurance companies, government programs, and other payers for services provided to Northpoint patients and clients
• Resolve rejected electronic claims so that current submission is successful and future submissions are not rejected
• Promptly resolve rejected claims for timely resubmission
• Conduct regular follow-up with insurance companies on claims statuses
• Knowledge of CMS and Third-party payer regulations and guidelines
• Manually process any claims that are not eligible for electronic submission
• Daily review and follow up of unbilled appointments in the system, ready to bill queues
• Ensure compliance with relevant healthcare regulations, HIPAA, and stay up-to-date with changes in billing and reimbursement guidelines
• Collaborate with other departments, such as clinical staff and administrative teams, to resolve billing and payment issues and improve processes
• Utilize a strong understanding of insurance billing and coding requirements
• Maintain active working knowledge of Northpoint billing and reimbursement requirements by payer
• Collaborate with RCM team and other departments to ensure successful execution of assigned duties and priorities
• Maintain confidentiality in accordance with established policies and procedures and standards of care
• Adhere to all Company policies and procedures
• Perform other job-related duties as assigned

QUALIFICATIONS/REQUIREMENTS FOR POSITION:

• 3+ years of medical billing, payer relations, or medical A/R experience in a healthcare system required
• 1+ year of experience in substance use disorder and/or mental health setting preferred
• Experience with a facility providing multiple levels of care is also preferred
• Experience working with commercial medical insurance billing, claims submission, and the technical aspects of billing software
• All-in-one practice management, clearing house and billing software required
• Must be proficient with HCPCS/CPT, ICD-10 Coding, DSMS and ASAM criteria, and various data entry systems for 3rd party billing and payers, and their reimbursement and denial patterns
• Ability to work well in a team environment with ability to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion
• Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
• Knowledge of navigating through payer portals
• KIPU or similar EHR/EMR experience preferred
• Agility in managing multiple priorities, with strong organizational and time management skills
• Meticulous attention to detail and high level of accuracy is key
• Demonstrated ability to develop both internal and external working relationships
• Proven skills in working independently on several projects concurrently
• Must be at least twenty-one (21) years of age

PREFERRED KNOWLEDGE AND SKILLS:

• Sense of ethics, integrity, and confidentiality about employee and business issues
• Ability to work independently and within a dynamic team environment
• Maintain professional and technical knowledge
• Excellent critical thinking skills and organizational abilities
• Excellent communication skills; ability to communicate clearly and concisely, verbally and in writing
• Quickly and effectively identify and resolve problematic situations
• Comfortable analyzing information and dealing with complexity
• Attention to detail and accuracy
• Able to handle confidential material in a reliable manner
• Ability to interact and communicate with individuals at all levels of organization
• Ability to perform several tasks concurrently with ease and professionalism
• Ability to effectively prioritize workload in a fast-paced environment
• Proficiency with Microsoft Office Suite

FULL-TIME BENEFITS INCLUDE:

• Subsidized Health Insurance Coverage for Employee, Spouse, & Dependent(s)
• 100% Employer Paid Basic Life Insurance equal to 1x annual salary, up to $100,000
• 100% Employer Paid Employee Assistance Program
• Voluntary Dental, Vision, Short-Term Disability, Supplemental Life & AD&D, Critical Illness, Accident, and Hospital Indemnity Insurance.
• Pre-tax Savings Accounts for all IRS-allowable medical and dependent care expenses
• Generous Paid Time Off plan and 10 Paid Holidays annually
• Employee Referral Bonuses
• 401K Retirement Plan & Employer Match

This job description is not intended, and should not be construed, to be exhaustive lists of all responsibilities, skills, efforts or working conditions associated with this job. It is meant to be an accurate reflection of the principal job elements essential for making fair pay decisions about jobs.

Employees with potential access to protected health information must comply with all procedures and guidelines governed by HIPAA.

Northpoint is an Equal Opportunity Employer. Northpoint is an at-will employer. Employment may be terminated at any time by employee, or employer with or without notice.