Senior Behavioral Health and SUD Billing Specialist for a multi-entity healthcare organization serving residential substance use disorder treatment, detox, intensive outpatient (IOP), outpatient behavioral health, and professional provider billing.
This role supports billing operations across three related Louisiana healthcare entities and reports to the Revenue Cycle Manager. The position is primarily office-based in the Mandeville/Covington area, with flexibility to work remotely 1–2 days per week. The selected candidate will help transition billing functions from an outsourced vendor to the internal team and will be expected to independently investigate billing issues, follow claims through resolution, and communicate findings and recommendations to management.
Key responsibilities include:
- Preparing, reviewing, submitting, and tracking claims across multiple healthcare entities
- Processing residential SUD, detox, IOP, outpatient, and professional provider claims
- Ensuring correct use of CPT, HCPCS, ICD-10, modifiers, and place-of-service codes
- Verifying payer requirements, authorizations, approved units, and dates of service
- Resolving clearinghouse rejections and claim submission errors
- Monitoring claim acceptance and timely-filing deadlines
- Maintaining accurate billing records
- Researching denied, rejected, and unpaid claims
- Preparing corrected claims, reconsiderations, and appeals
- Reviewing EOBs and ERAs for payment discrepancies
- Working aging A/R accounts and following claims through resolution
- Contacting insurance companies to resolve outstanding balances
- Identifying underpayments and reimbursement discrepancies
- Supporting the transition from outsourced billing to internal billing operations
- Assisting with standardized billing workflows and procedures
- Preparing regular reports on A/R, denials, claim status, and collections
- Collaborating with clinical, administrative, and authorization teams to resolve billing issues
Minimum qualifications:
- 3–5 years of medical billing or revenue-cycle experience
- Hands-on Louisiana Medicaid and Medicaid managed-care billing experience
- Strong understanding of behavioral health and/or SUD billing
- Experience with residential, outpatient, or professional healthcare claims
- Advanced denial-management and A/R follow-up skills
- Strong understanding of CPT, HCPCS, ICD-10, modifiers, and place-of-service requirements
- Experience with prior authorizations, medical necessity requirements, and payer guidelines
- Ability to independently investigate and resolve complex claims
- Strong organizational, communication, and problem-solving skills
- Ability to manage assigned billing responsibilities across multiple entities
Preferred experience:
- Residential SUD, detox, and IOP billing experience
- Professional billing for physicians and nurse practitioners
- Louisiana Medicaid managed-care organization experience
- Experience with LightningStep/Sunwave, KIPU, CollaborateMD, Availity, and clearinghouse systems
- Experience with multiple tax identification numbers and provider entities
- Experience assisting with a transition from outsourced to internal billing
- Experience with payer contract reimbursement and underpayment identification
- Hybrid schedule with flexibility to work remotely 1–2 days per week
- Opportunity to help build and transition an internal billing team
- Additional onsite flexibility during onboarding and billing transition
Location
Louisiana, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
Yes
Posted
4 weeks ago