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DIRECTOR OF BEHAVIORAL HEALTH REVENUE CYCLE, UTILIZATION MANAGEMENT & CREDENTIALING

Sanctuary Louisiana, LLC — Lacassine, Louisiana Full-Time | In-House Position $100,000 Starting Salary + Benefits + $5,000 Signing Bonus Sanctuary Louisiana is seeking an experienced, senior-level behavioral health revenue-cycle professional to lead our in-house billing, utilization management, prior authorization, credentialing, and revenue-cycle operations. This is not an entry-level billing position. We are looking for a proven professional who can take ownership of the entire reimbursement process—from credentialing and insurance verification through authorization, utilization review, billing, collections, denials, appeals, and accounts-receivable management. The successful candidate will work directly with Sanctuary Louisiana leadership and will have administrative support. Primary Responsibilities The Director will oversee and be accountable for: Louisiana Medicaid and Medicaid MCO billing Commercial/private insurance billing Facility and provider credentialing and recredentialing Medicaid and commercial payer enrollment CAQH maintenance, where applicable Payer contracting and credentialing follow-up Maintaining credentialing and recredentialing deadlines Insurance eligibility and benefits verification Prior authorizations and precertifications Concurrent reviews and continued-stay authorizations Utilization review and utilization management Medical-necessity review and documentation coordination Tracking authorization dates, units, levels of care and expirations Peer-to-peer review coordination Claims preparation and submission Claims follow-up Corrected claims and resubmissions Denial management Reconsiderations and appeals Payment posting and reconciliation oversight Identifying underpayments and unpaid claims Timely-filing management Accounts receivable management Insurance-aging and patient-aging reports Maintaining payer portals and clearinghouse processes Monitoring payer contracts and reimbursement requirements Developing and maintaining internal billing controls Producing regular revenue-cycle reports for ownership and management Supervising and training billing/administrative support personnel Alevia Experience Required Hands-on Alevia experience is required for this position. The successful candidate must understand how clinical documentation, authorizations, utilization review, credentialing and billing interact within Alevia and must be capable of independently managing those processes. What We Expect We are looking for someone who understands the entire behavioral-health revenue cycle , not simply someone who knows how to submit a claim. This individual should be able to tell management at any time: What have we billed? What has been paid? What remains outstanding? Why hasn't it been paid? What claims have been denied and why? What needs to be appealed? What authorizations are approaching expiration? What claims are approaching timely-filing deadlines? Are our providers and facilities properly credentialed? Are we being reimbursed according to our payer agreements? What is our current A/R, and what is the plan to collect it? We want a professional who can identify a revenue-cycle problem before it becomes a revenue problem. Preferred Experience Qualified candidates should have substantial experience with behavioral health and/or substance-use-disorder treatment billing and reimbursement. Strong preference will be given to candidates with direct experience involving: Louisiana Medicaid

• Louisiana Medicaid MCOs
• Behavioral Health/SUD Treatment
• Residential Treatment
• IOP/OP
• Commercial Insurance
• Alevia
• Credentialing
• Prior Authorization
• Utilization Review
• Denials & Appeals
• Revenue-Cycle Management Candidates should also possess strong knowledge of HIPAA requirements and demonstrate the ability to communicate effectively with payers, clinical personnel, providers and executive management.

Compensation & Signing Bonus Starting Salary:

$100,000 annually Benefits Package $5,000 Signing Bonus The signing bonus will be subject to a separate written retention agreement requiring 12 months of continued employment , with repayment provisions applicable if the employee voluntarily leaves before completing the required period. Compensation reflects the responsibility and level of expertise expected from this position. This Is an In-House Leadership Position This is a full-time, on-site position at Sanctuary Louisiana in Lacassine, Louisiana. We are specifically seeking an experienced professional who wants to take ownership of the revenue-cycle operation and build a strong internal billing and utilization-management department. The Director will have support from existing personnel for administrative and billing-related duties. Apply Please submit a resume detailing your experience with: Alevia, Louisiana Medicaid, Medicaid MCOs, behavioral-health billing, credentialing, prior authorizations, utilization review, claims management, denials and appeals, and accounts receivable. Applicants should specifically identify their Alevia experience , years of behavioral-health revenue-cycle experience, payer experience, and the types and levels of care for which they have managed billing and utilization. Sanctuary Louisiana, LLC is an Equal Opportunity Employer.

Pay:

From $100,000.00 per year

Benefits:

Dental insurance Health insurance Vision insurance

Work Location:

In person