Gentle Guardians Counseling Center is seeking an experienced and highly organized Certified Professional Coder (CPC) to support the financial and administrative operations of an outpatient mental health practice.
This role supports revenue cycle operations, client billing, denial management, credentialing, payroll support, and related administrative responsibilities while maintaining accuracy, professionalism, and client privacy.
Key Responsibilities
Insurance Billing & Revenue Cycle Management
- Submit accurate and timely behavioral health claims to commercial insurance companies, Medicaid, and other applicable payers
- Review claims for coding, documentation, authorization, and billing accuracy
- Verify insurance benefits and eligibility as needed
- Post and reconcile insurance payments, adjustments, and client responsibility
- Monitor accounts receivable and follow up on outstanding insurance claims
- Identify unpaid, rejected, or underpaid claims and take appropriate follow-up action
- Maintain accurate billing records and documentation
Denial Management & Appeals
- Review insurance denials and determine the reason for nonpayment
- Correct and resubmit claims when appropriate
- Prepare and submit appeals and supporting documentation
- Follow up with insurance companies regarding claim status and payment discrepancies
- Identify recurring denial patterns and recommend process improvements
- Track denial trends and communicate significant issues to leadership
Client Billing & Payment Collection
- Maintain accurate client account balances
- Process client payments and payment methods in accordance with agency procedures
- Communicate professionally and compassionately with clients regarding balances, deductibles, copays, coinsurance, and payment responsibilities
- Follow agency procedures for collecting outstanding client balances
- Assist in resolving billing questions and account discrepancies
Provider Credentialing
- Complete and maintain provider credentialing and recredentialing with insurance companies
- Assist with CAQH profiles and payer enrollment applications
- Track credentialing applications and follow up with insurance companies
- Maintain accurate records of provider participation, effective dates, recredentialing deadlines, and payer requirements
- Support enrollment of new clinicians with applicable insurance networks
Payroll & Administrative Support
- Assist with preparing and processing payroll accurately and on schedule
- Review relevant payroll information for accuracy
- Maintain appropriate payroll documentation and confidentiality
- Coordinate with leadership regarding discrepancies or necessary corrections
- Support financial and administrative reporting as assigned
Compliance & Confidentiality
- Maintain strict confidentiality of client, employee, financial, and organizational information
- Follow HIPAA Privacy and Security requirements when accessing, using, storing, or communicating protected health information
- Follow applicable payer requirements, coding standards, and agency policies and procedures
- Maintain organized and accurate records
- Participate in internal compliance efforts and process improvements
- Report billing, privacy, or compliance concerns through appropriate agency channels
Requirements & Qualifications
- Current Certified Professional Coder (CPC) certification through AAPC
- Experience with medical billing, coding, claims submission, payment posting, and accounts receivable
- Knowledge of ICD-10-CM, CPT, and HCPCS coding
- Understanding of HIPAA privacy and security requirements
- Strong attention to detail and ability to maintain accurate records
- Strong written and verbal communication skills
- Ability to communicate professionally with clients, clinicians, insurance companies, and other stakeholders
- Ability to manage multiple responsibilities, deadlines, and follow-up tasks independently
- High level of discretion when handling confidential information
Preferred Qualifications
- Previous billing or revenue cycle experience in an outpatient mental health or behavioral health practice
- Experience billing psychotherapy and behavioral health services
- Experience working with Medicaid and commercial insurance plans
- Experience with provider credentialing, CAQH, and payer enrollment
- Experience with denial management and insurance appeals
- Experience collecting client balances and resolving billing concerns
- Experience assisting with payroll
- Familiarity with electronic health record and practice management systems
- Experience working in a multi-provider behavioral health practice
Benefits & Perks
- 401(k) matching
- Flexible schedule
Location
Utah, US
Employment Type
Part-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 week ago