Senior Medical Billing Specialist

South Point Counseling Services, LLC; Utah; Sur place; USD 58 000 - 62 000; Plein temps

Avantages offerts par ce poste

Health insurance

Dental & vision

Paid time off

401(k) retirement plan

Résumé du poste

South Point Counseling Services, LLC in Utah is seeking a Senior Medical Billing Specialist to lead billing operations, supervise staff, and ensure accurate reimbursement for behavioral health services.

Candidates should have at least five years of medical billing experience, familiarity with Medicaid/Medicare, CPT codes for behavioral health, and proficiency with TherapyNotes, Optum ProviderConnect NX, and PRISM.

Qualifications

• Minimum of 5 years of medical billing experience.
• Strong knowledge of insurance claims processing, denials, appeals, payment posting, and accounts receivable.
• Experience with commercial insurance, Medicaid, and Medicare.

Responsabilités

• Submit electronic and paper insurance claims and post payments from ERA reports.
• Monitor claim submissions, rejections, denials, and payment discrepancies.
• Investigate and resolve complex billing issues and follow up on outstanding claims.

Connaissances

Medical billing

Insurance claims

Denials & appeals

Accounts receivable

Organization

Customer service

Attention to detail

Mentoring

Formation

CPB or CPC certification

Outils

TherapyNotes

Optum ProviderConnect NX

Utah Medicaid PRISM

Description du poste

About Us

South Point Counseling Services (SPCS) is an established and growing outpatient behavioral health practice serving individuals, couples, children, and families throughout Utah. Our multidisciplinary team provides mental health counseling, psychological assessments, psychiatric medication management, and specialized behavioral health services.

We are seeking an experienced, highly organized, and dependable Senior Medical Billing Specialist to help lead our billing operations, support our billing team, and ensure accurate and timely reimbursement for services provided.

KEY RESPONSIBILITIES

Medical Billing and Revenue Cycle Management

• Submit electronic and paper insurance claims and accurately post/adjust payments from Electronic Remittance Advice (ERA) reports.
• Monitor electronic claim submissions, rejections, denials, and payment discrepancies.
• Investigate and resolve complex insurance billing issues.
• Follow up on outstanding insurance claims and accounts receivable.
• Submit corrected claims, reconsiderations, and appeals as necessary.
• Monitor insurance and patient aging reports.
• Oversee and improve collection processes to reduce outstanding insurance/patient accounts receivable.
• Review payment posting, adjustments, and insurance reimbursements for accuracy.
• Ensure compliance with payer requirements, billing regulations, and company policies.

Team Leadership and Training

• Provide day-to-day guidance and support to billing staff.
• Train new billing employees on billing procedures, insurance requirements, and practice management systems.
• Monitor workflow, identify problems, and recommend process improvements.
• Review, update, and enhance the Billing Tasks Statement of Policy to ensure accuracy, consistency, and alignment with current billing procedures and regulatory requirements.
• Communicate billing concerns and operational updates to management.

Insurance and Patient Accounts

• Communicate with insurance companies regarding claims, eligibility, benefits, and reimbursement issues.
• Assist with resolving patient balances and payment discrepancies.
• Coordinate with clinical and administrative staff to resolve billing-related issues.
• Provide exceptional customer service, including professionally handling difficult conversations, resolving patient complaints, and assisting upset or frustrated clients with patience, empathy, and respect.

Reporting and Quality Assurance

• Conduct annual quality assurance reviews by sampling and auditing patient accounts to verify compliance with Optum Medicaid requirements, including OQ and MHER standards.
• Prepare regular reports on collections, outstanding claims, denials, and accounts receivable.
• Identify recurring billing errors and recommend corrective actions.
• Monitor billing performance and support the financial health of the practice.
• Maintain confidentiality and comply with HIPAA requirements.

Required Qualifications

• Minimum of 5 years of medical billing experience.
• Strong knowledge of insurance claims processing, denials, appeals, payment posting, and accounts receivable.
• Experience working with commercial insurance, Medicaid, and Medicare.
• Demonstrated ability to independently resolve complex billing issues.
• Excellent organizational, analytical, and problem-solving skills.
• Strong communication and customer service skills.
• Ability to prioritize responsibilities and meet deadlines.
• High level of accuracy, professionalism, and accountability.
• Experience training or mentoring billing staff.

Preferred Qualifications

• Experience in outpatient mental health or behavioral health billing.
• Proficiency in using TherapyNotes , Optum ProviderConnect NX , and Utah Medicaid PRISM .
• Familiarity with Utah Medicaid, Optum Medicaid, Medicare, SelectHealth, and other behavioral health insurance payers.
• Experience supervising or coordinating a small billing team.
• Knowledge of CPT codes commonly used in behavioral health, including psychotherapy, psychological testing, and psychiatric medication management.
• Certified Professional Biller (CPB) or Certified Professional Coder (CPC) credential.

Compensation and Benefits

Annual salary of $58,240-$62,400, based on qualifications and experience.

• Health insurance benefits for eligible employees.
• Dental and vision insurance options.
• Paid time off and paid holidays.
• 401(k) retirement plan with company matching, subject to eligibility.
• Supportive, professional work environment.
• Opportunity to contribute to the continued growth and improvement of an established behavioral health practice.

What We Are Looking For

We are looking for someone who takes ownership of their work, demonstrates sound judgment, and can identify and resolve billing problems without requiring constant supervision.

The successful candidate will be detail-oriented, proactive, dependable, and comfortable providing guidance to other team members while remaining actively involved in daily billing responsibilities.

This is a hands-on senior position requiring both technical billing expertise and the ability to help maintain an organized, efficient, and accountable billing department.

SPCS is an equal opportunity employer.