Job Description

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 one thousand employees, and over 40 years’ experience.

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 40% company match after 1 year of service. Generous PTO includes 3 weeks of vacation your 1st year (available after 6 months) and accruals after 2, 5 and 10 years of service! We offer low cost -medical, dental, STD, LTD, and Life coverage for employees. Other great benefits include 10 paid holidays, sick time, vision, tuition reimbursement prescription drug discounts, chiropractic services, and much more!

                                                Looking for an outgoing customer service oriented Credentialing/Billing Specialist to join our Client Financial Services team!!

The Credentialing/Billing Specialist is responsible for assisting in providing credentialing to our Licensed Staff through the processing of applications and reapplications to ensure that only qualified practitioners provide care within our facilities. Assist in maintaining accurate, up-to-date provider and site data to include updates, changes, additions, renewals and terminations in credentialing, while working under required timelines.  Communicate with providers to request missing information, follow accurate submission protocol for each entity, and track statuses of staff member and sites until credentialed.  Responsible for accurate and timely billing of electronic and hardcopy Behavioral Health and Medical claims. 

 

Duties & Responsibilities:

  • Responsible for SBH Site credentialing process to include entering/logging/scanning information into APEP, CAQH, Lexis Nexis for initial, updating, and add on applications and maintenance processes.
  • Maintain high quality, timely and accurate licensing processes required by healthcare agencies per SBH policy and procedure.
  • Maintain all credentials files ensuring that all correspondence in the credentialing and reappointment process is accurately saved in SB&H Confluence and is knowledgeable and current on the process and legal/regulatory requirements.
  • Monitor collection of required information received; follow up on missing items and/or incomplete forms, submit follow up requests for completion status with all plans.
  • Update provider rosters based on plan requirements.
  • Assist in notifying and assisting providers in renewing expiring credentials such as licensure, RBHA’s, Medicare, AHCCCS, and various entities, as required by contract while ensuring that all credentials are current at all times.
  • Assist to ensure that all credentials files are current and complete pursuant to expiration date of medical licenses, board certification, professional-liability insurance coverage, DEA, XDEA (NADEAN/Suboxone Waiver) and other pertinent information, per SBH and/or client facility policy and procedures.
  • Capable of managing multiple tasks and/or projects while keeping supervisor and others notified of the status.
  • Ensure strict confidentiality at all times.

Education & Qualifications:

  • High School Diploma/GED required
  • Two years of clerical or administrative experience required.
  • Requires high level of knowledge and experience with Excel spreadsheets & Microsoft word
  • Minimum 2 years medical billing experience, which includes at least 1 years of electronic, claims submission
  • 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.

SB&H is a drug-free workplace, drug screening required. EOE

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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