Join Southwest Behavioral & Health for exceptional growth opportunities driven by our promote-from-within philosophy. We provide an EXCELLENT compensation and benefits package, including immediate participation in our 403(b) program with 20% company match after 1 year of service. Generous Paid Time Off (PTO) includes 3 weeks of time-off your 1st year (available after 6 months) and increased vacation accruals after 2, 5 and 10 years of service! We offer low cost medical insurance and offer 100% company-paid dental, Short Term Disability, Long Term Disability, and Life coverage for employees. Other great benefits include 10 paid holidays, vision, licensure/certification reimbursement, tuition reimbursement, prescription drug discounts, chiropractic services, 100% paid Employee Assistance Program, and much more!
Southwest Behavioral & Health Services is a large and growing, non-profit community-based provider of behavioral health services with locations throughout the Phoenix metropolitan area, rural Maricopa County, Gila, Pinal, Mohave, Coconino, and Yavapai Counties. We are a well-established voice in the community with more than 115 sites, over seven hundred employees, and 40 years’ experience.
We are currently looking for a Billing Specialist to join or Client Financial Services (CFS)Department. This position will be responsible for accurate and timely billing of electronic and hardcopy Behavioral Health claims. Creates and submits a large volume of electronic HCFA claims via the 5010 837p formats. Creates and submits electronic copy UB04 claims for SBH Level I services. Responsible for creating reports from SBH systems to identify billed/denied/paid services and work to completion. Ensures 95% of claims are billed within 2 months. Resolves issues with unpaid claims to ensure 90% of claims are in a paid status within 5 months.
- Submits timely and accurate electronic and/or hardcopy 837p and 837i and/or hard copy claims for behavioral health and Medical initial, resubmission, and adjustments claims according to the CFS billing schedules.
- Identifies, researches, and resolves unbilled services on a weekly basis and escalates issues to Manager as needed to ensure 95% of claims are billed within 1 month.
- Identifies, researches, and resolves denied claims within 1-4 weeks of denial date.
- Identifies, researches, and resolves rejected claims within a week of date billed and escalates issues to Billing Manager as needed to ensure 95% of claims are billed within 1 month.
- Creates reports of billed/paid/not-billed etc. for weekly review with Billing Manager.
- Communicates with insurance companies as needed to resolve claim issues
- Keeps Manager informed of weekly production of claims and problems interfering with successful claims submission.
- Responsible for thorough understanding of SBH, AHCCCS, and other insurance billing requirements and procedures.
- Responsible for accurate record keeping of all aspect of claims submission files.
- Assists in maintaining claim billing processes and procedure manuals.
- Utilizes CFS Managers and the CFS team to discuss, enhance, and resolve issues.
- Maintains strictest confidentiality and adheres to all HIPAA guidelines/regulations
- Prepares, reviews and submits monthly Invoices for contracts CFS is responsible to bill
- Assist in special projects and perform other related duties as needed and assigned
- High School Diploma or G.E.D. required, Associates degree preferred.
- Minimum 2 years medical billing experience, which includes at least 1 to 2 years of electronic, claims submission required.
- Experience with a variety of contractual reimbursement arrangements.
- Medical Billing Certification preferred.
- Requires knowledge of healthcare billing practices including CPT4, ICD 10, and State AHCCCS codes using HCFA1500/837p and UB04/837i requirements.
- Must have experience with automated billing systems.
- Requires high level of knowledge and experience with Excel spreadsheets & Microsoft word
- Knowledge of mental health and medical billing desired.
- Capable of managing multiple tasks and/or projects while keeping supervisor and others notified of the status.
- Requires excellent communication, problem solving, conflict resolution, and organizational skills.
Job Reference #: 5025