BH Billing

Trilogy Wellness LLC; Butler Township (PA); On-site; USD 25,000 - 39,000; Full time

Job summary

Trilogy Wellness LLC in Butler, PA is seeking a BH Billing Specialist to join our Revenue Cycle Management team for end-to-end behavioral health billing and credentialing in an in-person role.

You will manage payer contracting, provider and location credentialing, verification of insurance, prior authorizations, claims submission, and AR follow-up to ensure timely reimbursement in a behavioral health setting.

Qualifications

• Minimum of 2 years of experience in medical billing with a focus on behavioral health billing.
• Hands-on experience with payer contracting and credentialing for providers and locations.
• Experience in revenue cycle management, including claims submission, AR follow-up, and collections.
• Proficiency in insurance verification, coverage and benefits verification, and prior authorizations.
• Strong understanding of behavioral health billing rules and common denial reasons.
• Experience using billing/EHR systems for workflows and reconciling remits.

Responsibilities

• Manage behavioral health payer contracting processes, including applications and contract updates.
• Credential and re-credential behavioral health providers and locations with payers.
• Verify patient insurance coverage and benefits prior to services, documenting eligibility and copays.
• Obtain, track, and renew prior authorizations for behavioral health services.
• Prepare, review, and submit clean behavioral health claims to payers per rules and timelines.
• Monitor accounts receivable and identify aged balances and underpayments.
• Follow up on unpaid or denied claims; work denials and appeals to resolution.
• Post payments and adjustments; reconcile with remittance advices and EOBs.
• Identify and fix billing errors or documentation issues impacting payment.
• Communicate with payers, patients, and internal teams to resolve issues.
• Maintain up-to-date knowledge of billing, credentialing, and payer policies.
• Document all activities in the practice management/EHR systems.
• Support RCM process improvements and implement best practices.

Skills

Medical Billing

Behavioral Health Billing

Payer Contracting

Credentialing

AR Follow-up

Insurance Verification

Denials & Appeals

EHR Systems

HIPAA Compliance

Tools

Practice Management System

EHR Software

Job description

Our mission is to bring the highest quality of care to those individuals suffering from Opioid Use Disorder (OUD). We understand not only how difficult it can be to recover from addiction but that the road to recovery may be a long and bumpy one. And we know for sure that to achieve success, this road must be traveled with as much support as possible.

About The Role

The BH Billing Specialist is a key member of our Revenue Cycle Management (RCM) team, responsible for end-to-end behavioral health billing and credentialing activities. In this hourly, full-time role, you will manage payer contracting, provider and location credentialing, insurance and benefits verification, prior authorizations, claims submission, and accounts receivable follow-up. You will work closely with clinical and administrative staff to ensure accurate, timely reimbursement and a smooth financial experience for both patients and providers within a behavioral health setting. This position is in person in our Butler, PA location.

What You'll Do

• Manage behavioral health payer contracting processes for the organization, including completing applications, updating contracts, and maintaining payer records
• Credential and re-credential behavioral health providers and locations with commercial and government payers, ensuring all requirements and deadlines are met
• Verify patient insurance coverage and behavioral health benefits prior to services, documenting eligibility, copays, coinsurance, deductibles, and visit limits
• Obtain, track, and renew prior authorizations for behavioral health services, ensuring accurate clinical information and timely approvals
• Prepare, review, and submit clean behavioral health claims (electronic and paper) to payers in accordance with payer-specific billing rules and timelines
• Monitor and manage accounts receivable (AR), including identifying outstanding claims, aged balances, and underpayments
• Conduct proactive follow-ups on unpaid, denied, or rejected claims; work denials and appeals to resolution to maximize reimbursement
• Post payments and adjustments from payers and patients accurately and promptly, reconciling against remittance advices and EOBs
• Identify and correct billing errors, trends, or documentation issues that impact claim acceptance or payment
• Communicate with payers, patients, and internal teams to resolve billing, coverage, and authorization issues
• Maintain up-to-date knowledge of behavioral health billing, credentialing, and payer policies, including coverage and authorization requirements
• Document all billing, credentialing, verification, and follow-up activities in the practice management and/or EHR systems
• Support revenue cycle process improvements and help implement best practices for behavioral health RCM

Qualifications

• Minimum of 2 years of experience in medical billing with a focus on behavioral health billing
• Hands-on experience with behavioral health payer contracting and credentialing for providers and locations
• Demonstrated experience in revenue cycle management (RCM), including claims submission, AR follow-up, and collections
• Proficiency in insurance verification, coverage and benefits verification, and prior authorization workflows for behavioral health services
• Strong understanding of behavioral health billing requirements, payer rules, and common denial reasons
• Experience using practice management and/or EHR systems for billing, claims, and credentialing workflows
• Ability to interpret EOBs/ERAs, payer remittances, and resolve discrepancies or underpayments
• High attention to detail, accuracy, and organization in managing multiple payers, providers, and deadlines
• Strong written and verbal communication skills, with the ability to interact professionally with payers, patients, and internal teams
• Proven ability to work independently in a fast-paced environment while meeting productivity and quality standards
• Familiarity with HIPAA regulations and maintaining confidentiality of patient and practice information