Billing and Collections Specialist

Rite of Passage•Queen Creek, AZ

About The Position

The Billing and Collections Specialist is responsible for full-cycle outpatient behavioral health billing and collections, including charge entry, claim submission, payment posting, and accounts receivable follow-up. The position supports accurate and timely reimbursement by managing insurance claims, resolving denials and payment discrepancies, and coordinating with Medicaid, managed care organizations, commercial insurance payers, and internal departments. The role requires maintaining accurate billing records and account documentation while following payer requirements, company policies, and HIPAA. The specialist also works toward established billing, productivity, and collection goals. Rite of Passage describes its mission as helping youth build brighter futures and become successful adults.

Requirements

High school diploma or equivalent required.
Knowledge of insurance claims processing, denials management, and appeals.
Familiarity with Medicaid and managed care payer guidelines.
Strong analytical, organizational, and problem-solving skills.
Excellent communication and customer service abilities.
Ability to manage multiple accounts and deadlines effectively.
Proficiency in Microsoft Office Suite and healthcare billing systems.
Ability to pass a criminal background clearance check, drug screen, physical, and TB test.

Nice To Haves

Associate’s degree preferred.
Minimum of 2 years of healthcare collections or medical billing experience preferred.
Behavioral health, residential treatment, or Medicaid collections experience strongly preferred.
Experience with behavioral health, PRTF, or residential treatment billing.
Understanding of authorizations, eligibility verification, and coordination of benefits.
Knowledge of multi-state Medicaid billing processes.

Responsibilities

Perform full-cycle outpatient behavioral health billing, including charge entry, claim preparation, submission, and follow-up.
Review documentation, CPT/HCPCS codes, modifiers, authorizations, and insurance eligibility to ensure accurate billing.
Submit electronic and manual claims to Medicaid, managed care organizations (MCOs), and commercial insurance payers.
Post insurance and patient payments and adjustments, and reconcile payment discrepancies.
Monitor accounts receivable aging and follow up on outstanding insurance and patient balances.
Investigate and resolve rejected, denied, or underpaid claims, including corrections, reconsiderations, and appeals.
Review remittance advice (RA/EOB) to identify reimbursement discrepancies and denial trends.
Communicate with insurance payers and internal departments to resolve billing, authorization, and payment issues.
Maintain accurate billing records and account documentation while ensuring compliance with payer requirements, company policies, and HIPAA.
Meet established billing, productivity, and collection goals.