Billing Specialist

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 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 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!

Looking for a Billing Specialist to join our Client Financial Department! Billing Specialist -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.
• Excellent customer service skills required.

Duties & Responsibilities:

• Submits timely and accurate electronic and/or hardcopy behavioral health claims. (New, Resubmit, and Adjustments)
• Identifies, researches, and resolves unbilled encounters and escalates issues to Manager as needed to ensure 95% of claims are billed within 2 months.
• Identifies, researches, and resolves denied encounters within 6 months of service date.
• Identifies, researches, and resolves unbilled FFS claims and escalates issues to Manager as needed to ensure 95% of claims are billed within 2 months.
• Identifies, researches, and resolves denied FFS claims within 6 months of service date. Creates reports of billed/paid/not-billed etc. for bi-weekly review with Billing Manager.
• Keeps Manager informed of bi-weekly production of claims and problems interfering with successful claims submission. Responsible for thorough understanding of SBH, RBHA, and other payer billing requirements and procedures.
• Responsible for accurate record keeping of claims billing. Assists in maintaining claim billing process and procedure manuals. Utilizes Manager and the CFS team to discuss, enhance, and resolve issues. To ensure compliance & adequate services, additional job duties may be required to meet the needs of the program and or department.

Education & Qualifications:

• High School Diploma or G.E.D. Associates degree preferred.
• Minimum 1 - 2 years medical billing experience, which includes at least 1 year of electronic, claims submission required. Commercial insurance billing and accounts receivable experience preferred.
• Experience with a variety of contractual reimbursement arrangements.
• Medical and Billing Certification preferred.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

About SB&H

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 40 years experience.

To learn about Southwest Behavioral & Health Services mission, values and services please review our website at https://www.sbhservices.org/

Mission and Values

Our teams are working hard to ensure our Mission and Values are continuously modeled throughout our organization and in all of our daily interactions.

Delivering compassionate care to enhance lives and improve communities.

• Compassion
• Integrity
• Quality
• Empowerment
• Innovation
• Trust

SB&H is a drug-free workplace, drug screening required. Southwest Behavioral & Health Services is an Equal Employment Opportunity Employer. Southwest Behavioral & Health Services provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.