Billing & UR Specialist

Vive Adolescent Care; Saint George (UT); On-site; USD 42,000 - 64,000; Full time

Job summary

Vive Adolescent Care is seeking a Full Time Billing and Utilization Review (UR) Specialist to support weekday operations at our acute adolescent care facility in Saint George, Utah.

The ideal candidate has 2-3 years in medical billing, Medicaid knowledge, and UR experience, with strong customer service, accuracy, and ability to work on-site.

Responsibilities include submitting reimbursements to Medicare/Medicaid, handling denials, arranging self-pay plans, and coordinating prior authorizations.

Qualifications

• Two to three years of medical billing and coding experience required.
• Knowledge of Medicaid and insurance requirements for adolescent mental health services.
• Experience with Utilization Review (authorization requests, concurrent reviews, documentation coordination) preferred.
• Excellent customer service and phone manner.
• Strong time management and organizational skills.
• Current CPR and first aid certificate is required.
• History with billing AR is desired.

Responsibilities

• Submit reimbursement requests to Medicare, Medicaid, and private insurance.
• Process claims, enter charges, and post payments accurately and timely.
• Follow up on payer denials and resubmit claims.
• Develop self-pay arrangements and payment plans with patients and families.
• Initiate private pay collections as needed.
• Maintain confidential billing documentation and adjust accounts per policy.
• Submit and track prior authorizations for treatment services.
• Coordinate and conduct concurrent reviews with insurance companies.
• Ensure clinical documentation supports medical necessity and communicate updates to treatment teams.

Skills

Billing & coding

Medicaid billing

UR processes

Customer service

Time management

Education

High school diploma or GED

Associate degree or certification in medical billing/health info management

Job description

Our acute adolescent care facility is seeking a dedicated Full Time Billing and Utilization Review (UR) Specialist. This position is ideal for an experienced billing professional with strong knowledge of insurance and Medicaid billing, as well as experience with Utilization Review processes in a mental health or acute care setting. This role primarily supports weekday operations but may include flexible weekend hours as needed. The ideal candidate will be compassionate, detail-oriented, and proactive in helping patients and families navigate insurance, billing, and authorization processes.

Qualifications

Education

High school diploma/GED required. Associate degree or certification in medical billing, insurance coding, or health information management strongly preferred.

Training and Experience

• Two to three years of experience in medical billing and coding, preferably in a behavioral health or acute care setting required.
• Knowledge of Medicaid and insurance requirements for adolescent mental health services.
• Prior experience with Utilization Review processes (authorization requests, concurrent reviews, clinical documentation coordination) preferred.
• Excellent customer service skills and phone manner.
• Strong time management and organizational skills.
• Must possess a current certificate for CPR and first aid.
• History with billing AR

Accountabilities/Duties

Billing Responsibilities

Submit reimbursement requests to Medicare, Medicaid, and private insurance. Accurately process insurance claims, enter charges, and post payments in a timely manner.

Follow up on payer denials, re-submit claims, and resolve billing discrepancies.

Work with patients and families to develop self-pay arrangements and payment plans.

Initiate private pay collections as needed.

Maintain accurate and confidential billing documentation.

Adjust patient accounts accurately according to company policies and criteria.

Utilization Review Responsibilities

Submit and track prior authorizations for treatment services. Coordinate and conduct concurrent reviews with insurance companies. Ensure that clinical documentation supports medical necessity. Communicate authorization updates to treatment teams. Assist in tracking length of stay and discharge planning from a payer perspective. Document all UR activities accurately and timely.

• This position requires availability on weekdays and may include some flexible weekend hours.
• The candidate must be able to work independently with minimal supervision, maintaining confidentiality and professionalism at all times.
• Must have reliable transportation and the ability to work on-site.