Medical Billing Specialist

A BETTER LIFE RECOVERY LLC • San Juan Capistrano, CA

4d • Hybrid

About The Position

The Medical Billing Specialist is responsible for submitting timely, accurate, and clean healthcare claims to insurance carriers while actively monitoring and following up on outstanding claims through ongoing A/R analysis. This role works closely with the Billing Director to support the revenue cycle, maximize reimbursements, and ensure efficient financial operations across the organization.

AMFM Healthcare is a leading provider of evidence-based mental health treatment with programs spanning California, Washington, Virginia, and Minnesota. We are committed to delivering compassionate, individualized care through a network of specialized programs that support people across all stages of life and levels of need.

Our mission is to provide high-quality mental health treatment in settings that foster healing, connection, and long-term wellness. Every program under the AMFM umbrella is grounded in clinical excellence, integrity, and a deep respect for the personal stories of those we serve.

Our Programs Include:

A Mission for Michael: Our flagship program offers intensive, highly personalized residential mental health treatment in small, home-like environments. With a 6-8 client ratio per home, we provide 24/7 support from a multidisciplinary clinical team, incorporating traditional therapy, experiential modalities (art, music, equine), and a deep focus on each client’s lived experience.

Mission Connection: A flexible, hybrid program designed to meet clients where they are—both literally and clinically. This outpatient service combines in-person and telehealth care for adults with primary mental health diagnoses such as anxiety, depression, and mood disorders. Mission Connection ensures consistent, personalized support that fits into the client’s real life.

Mission Prep: A dedicated adolescent program that works with teens and their families to create sustainable change. Focused on treating primary mental health challenges, Mission Prep offers a blend of proven therapies and innovative interventions in a supportive, home-like setting. Family involvement is central to the treatment process, helping lay the foundation for long-term success and resilience.

From residential programs to hybrid and outpatient care, AMFM Healthcare is proud to offer a full continuum of mental health treatment options, delivered by passionate professionals who believe in treating the whole person—not just the diagnosis.

Requirements

• Must be at least 18 years old
• High School Diploma or GED required
• Minimum of 1 year of experience in medical billing, claim follow-up, and A/R analysis, preferably within behavioral health
• Successful completion of all required background and record checks, including ADP Selective Screening Services
• Ability to work on a computer and keyboard for extended periods
• Ability to communicate effectively in written and verbal formats
• Strong listening and reading comprehension skills
• Ability to sit for long periods of time
• Ability to lift up to 10 lbs.
• Strong written and verbal communication skills with the ability to build rapport with insurance representatives and internal teams
• Ability to maintain professionalism and positive working relationships across departments
• Working knowledge of medical billing terminology, CPT and ICD-10 coding, and behavioral health billing practices
• Strong organizational skills and attention to detail
• Proficiency with computer systems and ability to quickly learn new software platforms

Responsibilities

• Submit timely, accurate, and clean healthcare claims to insurance carriers
• Monitor and follow up on outstanding behavioral health claims across multiple insurance providers
• Contact payers via phone, email, and payer portals to investigate claim status and resolve billing issues
• Analyze denials and rejections, research coding and billing requirements, and prepare appeals to maximize reimbursement
• Maintain accurate documentation and update claim statuses throughout the follow-up process
• Assist with Single Case Agreements and out-of-network negotiation support as needed
• Negotiate pre-payment pricing terms with third-party vendors to secure competitive out-of-network rates
• Collaborate with billing, coding, and clinical teams to identify and resolve claim issues at the source
• Work with patients, providers, and insurance companies to resolve discrepancies and obtain missing information
• Analyze aging reports and denial trends to improve billing accuracy and reduce follow-up volume
• Identify opportunities for post-payment reconsiderations and ensure timely submission
• Utilize A/R software systems to generate reports, analyze trends, and improve collection strategies

Benefits

• Medical, Dental, and Vision plans through Anthem or Kaiser.
• FSA/HSA Accounts.
• Life/AD&D insurance through Anthem, 100% paid for by the employer.
• 401k plan with employer match.
• PTO, Self Care Day, and Floating Holiday.
• Educational Assistance Reimbursement Program.
• Employee Assistance Program.
• Health and Wellness Membership.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED