Billing Specialist

Odyssey House Inc.•Salt Lake City, UT

13d•Onsite

About The Position

Odyssey House is seeking a Full-Time Billing Specialist! Summary: Odyssey House's Mission is "Empowering people to heal and build better lives." We are dedicated to helping individuals and families reclaim their lives through effective substance use treatment, prevention, and mental health services. Our programs address education, job skills, healthcare, sober housing, behavioral management, and aftercare support to ensure lifelong success. We are proud to be the largest treatment provider in Utah with the most innovative programs available. ‘We Are Recovery,’ and we mean it with all of our hearts. Odyssey House’s Core Values Integrity (I) – We do what is best for the clients and community. Always Wholeheartedness (W) – We are sincere in our commitment towards a better life for all. Connection (C) – We seek opportunities to engage with one another. Personal Growth (G) – We are curious about how to be better versions of ourselves. Overview: The Billing Specialist will be responsible for overseeing the billing processes specific to medical, mental health, and substance abuse claims. This role focuses on minimizing denial rates and ensuring accurate, timely submissions to payers. The ideal candidate will possess a strong understanding of the revenue cycle, familiarity with coding and billing guidelines, and a commitment to optimizing revenue while maintaining compliance with regulations.

Requirements

Proven experience in healthcare billing, particularly in medical, mental health, and substance abuse claims management.
Strong knowledge of CPT, ICD-10, and HCPCS coding as they relate to mental health and substance abuse services.
Familiarity with revenue cycle software and electronic health record (EHR) systems.
Excellent analytical skills and attention to detail to minimize errors and denials.
Strong communication and interpersonal skills to facilitate collaboration with various stakeholders.
Ability to manage multiple tasks efficiently in a dynamic healthcare environment.
Bachelor’s degree in healthcare administration, finance, business, or a related field preferred, or equivalent work experience in medical billing.
Willingness and ability to pass a criminal background check
First Aid and CPR Certification (available at Odyssey House)
Must meet employment eligibility
Must be able to work variable shifts as needed
Employment offers are contingent upon successful completion of required pre-employment screenings, which may include background checks, fingerprinting, applicable sex offender registry screenings for Adult Residential roles, and other position-related verifications. Roles requiring driving are subject to a Motor Vehicle Record (MVR) review and valid Utah driver’s license.
All employees of Odyssey House are required to adhere to: Odyssey House mission, philosophy, and scope of service; Division of Human Services Code of Conduct and all other relevant service contract requirement standards; ensuring a safe environment for all clients and staff; providing exemplary customer service to both internal and external customers; fostering a positive work environment; ensuring high-quality client care within the scope of the assigned position.
Each employee is expected to clearly understand roles and responsibilities regarding the following: Specific job position, time management, personnel file requirements, client record system, incident reporting, mandatory training requirements, maintaining proper client boundaries, and individual rights of clients and staff.
Ability to lift up to 15 lbs., drive (or adequate alternate transportation), sit for prolonged periods, and perform light to moderate physical activity at times.

Responsibilities

Claims Submission: Accurately prepare and submit claims for services to insurance payers using appropriate coding and billing guidelines. o Ensure that all claims are submitted timely and follow payer-specific requirements to decrease the likelihood of denials.
Denial Prevention and Management: Monitor billing processes closely to identify potential issues that could lead to denied claims. Conduct thorough audits of claims prior to submission to ensure compliance with all coding and billing regulations. o Work to achieve minimal denial rates by implementing best practices in billing, coding, and documentation.
Collaboration and Communication: Collaborate with clinical staff to gather necessary documentation and ensure accurate coding for various services. Maintain effective communication with payers to clarify billing discrepancies and resolve issues proactively.
Accounts Receivable Management: Track and manage accounts receivable, ensuring follow-up on unpaid claims within established timelines. Address and resolve any inquiries from insurance companies regarding billing statements or claim statuses.
Reporting and Analysis: Analyze trends in denials and billing issues, providing recommendations for process improvements to enhance revenue cycle efficiency.
Education and Training: Stay updated on changes in billing practices, regulations, and payer policies specific to medical, mental health, and substance abuse claims. Participate in training initiatives to continually improve knowledge and skills related to coding, billing, and revenue cycle management.
Compliance Assurance: Ensure compliance with all relevant healthcare regulations, including HIPAA, state laws, and payer policies, to maintain the integrity of patient information and billing processes.