Billing Specialist- Behavioral Health & Substance Use

AHG MASTER•Palm Springs, FL

17h•Hybrid

About The Position

Are you an experienced Behavioral Health Billing Specialist looking to join a growing team that supports mental health and substance use treatment centers nationwide? We are seeking a detail-oriented professional with expertise in billing inpatient, outpatient, and ancillary services, applying CPT/HCPCS codes and modifiers, and navigating payer guidelines. If you have experience with Sunwave software and a passion for accuracy, this role is for you!

Requirements

Minimum 2 years of billing experience in mental health and substance use treatment.
Proficiency in applying modifiers correctly for professional and institutional claims.
Strong knowledge of CPT/HCPCS coding and payer guidelines.
Familiarity with CMS-1500 and UB-04 claim forms.
Excellent attention to detail, organizational, and communication skills.
Ability to work independently and meet deadlines.
High School Diploma or equivalent (required).

Nice To Haves

Experience with Sunwave billing software.
Associate’s or Bachelor’s degree in Healthcare Administration, Business, or related field (preferred).

Responsibilities

Submit professional and institutional claims (CMS-1500 and UB-04) for behavioral health and substance use services.
Apply correct CPT/HCPCS codes and modifiers for inpatient, outpatient, and ancillary services.
Verify insurance coverage, authorizations, and referral numbers prior to billing.
Reconcile monthly billing to ensure all services rendered are billed.
Review EOBs, resolve denials, and manage voids, corrections and re-submissions promptly.
Maintain compliance with Medicare, Medicaid, commercial payer, and VA CCN guidelines.
Utilize Sunwave software for claim entry, tracking, and reporting (preferred).
Communicate with treatment centers and payers to resolve billing issues.
Collaborate with internal teams to improve revenue cycle processes.