MENTAL HEALTH / SUBSTANCE ABUSE BILLER/UR

Overview Join our dynamic healthcare team as a Mental Health / Substance Abuse Biller/UR specialist, where your expertise will play a vital role in ensuring accurate and efficient billing processes for mental health and substance abuse services. In this role, you will handle complex medical coding, billing, and utilization review tasks to support seamless reimbursement and compliance. Your proactive approach will help optimize revenue cycles while maintaining the highest standards of accuracy and integrity. This position offers an exciting opportunity to contribute to quality patient care through meticulous billing practices and effective documentation. Duties Review and verify medical records, treatment documentation, and clinical notes to ensure proper coding for mental health and substance abuse services. Apply appropriate DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology), ICD-9, and ICD-10 codes to accurately bill for services rendered. Conduct thorough medical billing processes using EMR (Electronic Medical Records) and EHR (Electronic Health Records) systems, ensuring timely submission of claims. Perform utilization review (UR) activities to assess the necessity, appropriateness, and efficiency of patient care services in compliance with insurance guidelines. Follow up on unpaid or denied claims through effective medical collection strategies, resolving discrepancies promptly. Maintain detailed and organized medical records, ensuring all documentation aligns with billing requirements and regulatory standards. Stay updated on industry regulations, coding changes, and payer policies to ensure ongoing compliance and optimize reimbursement. Ensure timely authorizations. Manage Appeal Qualifications Proven experience in medical billing within mental health or substance abuse settings; familiarity with behavioral health billing is highly preferred. Strong knowledge of

DRG, CPT

coding, ICD-9, ICD-10 coding systems, and medical terminology. Experience working with EMR/EHR systems for documentation and billing purposes. Solid understanding of medical records management, insurance claim procedures, and medical collection processes. Excellent attention to detail with the ability to interpret complex clinical documentation accurately. Knowledge of healthcare regulations related to mental health/substance abuse billing practices. Prior experience with medical coding, ICD coding updates, and familiarity with medical office workflows is a plus. Embark on a rewarding career where your skills directly impact patient care quality while supporting the financial health of our organization! Prior experience with utilization review for substance abuse and mental health

Pay:

$20.00 - $35.00 per hour

Work Location:

Hybrid remote in Murrieta, CA 92562