Prior Authorization Billing Specialist

Education

• High School Diploma or GED required
• Associate's or bachelor's degree in healthcare administration preferred

Experience

• 3+ years of experience in credentialing, prior authorization, and insurance reimbursement preferred
• Experience in behavioral health and substance use disorder treatment preferred

Skills and Knowledge

• Strong understanding of prior authorization, insurance reimbursement, billing, and coding processes
• Knowledge of CPT, ICD-10, and HCPCS coding
• Experience with Medicaid and private insurance carriers
• Proficiency with billing software and EMR systems
• In-depth knowledge of credentialing systems and procedures, including MITS and PNM
• Proficient in data entry
• Working knowledge of Microsoft Office Suite and Google Workspace
• Strong written and verbal communication skills
• Excellent problem-solving, decision-making, and organizational skills
• Ability to manage multiple tasks and deadlines simultaneously
• Understanding of HIPAA and confidentiality requirements
• Knowledge of federal, state, and municipal laws related to addiction treatment

Other Requirements

• Ability to work under pressure and prioritize responsibilities
• Must maintain professionalism, confidentiality, and compliance with patient rights and ethics standards

Benefits

• Competitive pay
• 401(k) with employer match
• Generous paid time off
• Tuition reimbursement
• Medical insurance
• Dental insurance
• Vision insurance
• Employee assistance program