Full Job Description About Us:

Border Area Mental Health Services, Inc. (BAMHS) dba Southwest Counseling Center (SWCC), is a nonprofit organization providing behavioral and medical health services throughout Southern New Mexico. We are committed to improving the health and well-being of our communities through high-quality, compassionate care. We are seeking a detail-oriented and experienced Billing & Coding Specialist to join our team.

Position Summary:

The Billing & Coding Specialist is responsible for medical coding, claim preparation and submission, payment posting, denial management, collections, account reconciliation, and billing compliance activities. This position plays a critical role in ensuring services are accurately documented, coded, billed, and reimbursed in accordance with payer requirements and applicable regulations.

Essential Duties and Responsibilities:

Review clinical documentation and assign appropriate CPT, HCPCS, ICD-10-CM, and other applicable billing codes. Verify coding accuracy and compliance with payer requirements, agency policies, and regulatory guidelines. Prepare and submit electronic claims for medical and behavioral health services. Review claims for completeness and accuracy prior to submission. Correct and resubmit denied or rejected claims. Investigate and resolve billing issues, insurance discrepancies, and claim denials. Follow up with insurance companies regarding unpaid, denied, or underpaid claims. Initiate and manage private-pay collection efforts when necessary. Maintain accurate patient and insurance records. Respond to patient and insurance company inquiries regarding billing matters. Generate and distribute patient statements. Establish payment arrangements for current and delinquent accounts. Conduct chart audits to verify coding accuracy, documentation requirements, modifier usage, supervisory requirements, and payer compliance standards. Identify coding and billing trends that may place the organization at risk for denials, recoupments, or audit findings. Assist providers and supervisors with understanding documentation requirements needed to support compliant billing practices. Participate in internal audits, compliance reviews, and quality improvement initiatives. Assist with reports related to billing, collections, reimbursement trends, coding accuracy, and revenue cycle performance. Maintain patient confidentiality in accordance with HIPAA regulations. Perform other duties as assigned.

Qualifications Required :

Knowledge of healthcare reimbursement and third-party payer regulations. Knowledge of CPT, HCPCS, and

ICD-10-CM

coding systems. Strong attention to detail and organizational skills. Excellent written, verbal, and interpersonal communication skills. Ability to analyze problems and make timely decisions. Proficiency with electronic health records, billing software, and practice management systems. Valid driver's license, reliable transportation, and proof of liability insurance.

Preferred:

Three (3) or more years of medical billing and coding experience. Certification such as CPC, CCS, COC, or equivalent. Bachelor's degree in Business, Healthcare Administration, Health Information Management, or related field. Experience with behavioral and medical health billing, Medicaid, Medicare, and commercial insurance claims.

Benefits:

BAMHS/SWCC

offers a comprehensive benefits package that may include: Medical, dental, and vision insurance Paid time off (PTO) Paid holidays Retirement plan options Professional development opportunities Supportive team environment

Physical Requirements:

This position requires prolonged sitting, computer use, standing, walking, bending, and occasional lifting of up to 30 pounds. The work environment is generally quiet and office-based. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential functions of the position.

Equal Opportunity Employer:

BAMHS is an Equal Opportunity Employer and is committed to creating an inclusive workplace for all employees and applicants. Apply today!!

Pay:

$55,000.00 - $65,000.00 per year

Benefits:

401(k) matching Health insurance Life insurance Paid time off Vision insurance

Education:

Bachelor's (Required)

License/Certification:

Medical Coding Certification (CPC, CCS, COC or equivalent) (Preferred) Willingness to travel: 25% (Preferred)

Work Location:

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