Senior Behavioral Health & SUD Billing Specialist

Senior Behavioral Health & SUD Billing Specialist

Location: Mandeville/Metairie, Louisiana

Employment Type: Full-Time | Hybrid Work Schedule: Primarily onsite, with flexibility to work remotely 1–2 days per week Proposed

Compensation: $20–$30/hour, based on experience

Reports To: Revenue Cycle Manager

Position Overview

We are seeking an experienced Senior Behavioral Health & SUD Billing Specialist to join our internal billing team and support billing operations across three related Louisiana healthcare entities.

Our services include residential substance use disorder treatment, detox, intensive outpatient programs (IOP), outpatient behavioral health services, and professional provider billing.

The ideal candidate will have extensive hands-on experience with Louisiana Medicaid managed-care organizations, claim submission, denial resolution, accounts receivable, authorizations, and payer follow-up.

The selected candidate will work directly under the Revenue Cycle Manager and will be expected to independently investigate billing issues, follow assigned claims through resolution, and communicate findings and recommendations to management.

This position will also assist with transitioning billing functions from an outsourced billing arrangement to our internal team. This is not an entry-level position or a revenue-cycle management role.

We are seeking a highly experienced billing professional who can work independently while operating under the direction and oversight of the Revenue Cycle Manager.

Key Responsibilities

Claims Processing & Billing

• Prepare, review, submit, and track claims across three separate healthcare entities.
• Process residential SUD, detox, IOP, outpatient, and professional provider claims.
• Ensure accurate use of CPT, HCPCS, ICD-10, modifiers, and place-of-service codes.
• Verify payer requirements, authorizations, approved units, and dates of service.
• Identify and resolve clearinghouse rejections and claim submission errors.
• Monitor claim acceptance and timely-filing deadlines.
• Maintain accurate billing records for each entity.

Denial Management & Accounts Receivable

• Independently research denied, rejected, and unpaid claims.
• Prepare corrected claims, reconsiderations, and appeals.
• Review EOBs and ERAs to identify payment discrepancies.
• Work assigned aging A/R accounts and prioritize claims requiring immediate attention.
• Contact insurance companies to resolve outstanding balances.
• Identify underpayments and reimbursement discrepancies.
• Monitor payer responses and follow claims through resolution.
• Identify recurring denial trends and report findings to the Revenue Cycle Manager.

Billing Transition Support

• Assist with transitioning billing functions from an external billing company to the internal billing team.
• Review outstanding A/R and unresolved claims during the transition.
• Assist with implementing standardized billing workflows and procedures.
• Identify gaps in authorizations, documentation, claim processing, and payment posting.
• Support billing software and clearinghouse workflows.
• Help maintain timely claims processing and consistent cash flow throughout the transition.

Reporting & Collaboration

• Prepare regular reports on outstanding A/R, denials, claim status, and collections.
• Communicate billing concerns and recommendations to the Revenue Cycle Manager.
• Collaborate with clinical, administrative, and authorization teams to resolve billing issues.
• Identify opportunities to improve billing accuracy and reduce preventable denials.
• Follow established billing policies and recommend process improvements.

Required Qualifications

• Minimum 3–5 years of medical billing or revenue-cycle experience.
• Hands-on Louisiana Medicaid and Medicaid managed-care billing experience.
• Strong understanding of behavioral health and/or SUD billing.
• Experience with residential, outpatient, or professional healthcare claims.
• Advanced denial-management and A/R follow-up skills.
• Strong understanding of CPT, HCPCS, ICD-10, modifiers, and place-of-service requirements.
• Experience with prior authorizations, medical necessity requirements, and payer guidelines.
• Ability to independently investigate and resolve complex claims.
• Strong organizational, communication, and problem-solving skills.
• Ability to manage assigned billing responsibilities across multiple entities.

Preferred Qualifications

• Residential SUD, detox, and IOP billing experience.
• Professional billing experience for physicians and nurse practitioners.
• Experience with Louisiana Medicaid managed-care organizations.
• Experience with LightningStep/Sunwave.
• Experience with KIPU.
• Experience with CollaborateMD.
• Familiarity with Availity and clearinghouse systems.
• Experience working with multiple tax identification numbers and provider entities. - Experience assisting with the transition from outsourced to internal billing.
• Experience with payer contract reimbursement and underpayment identification. Experience with all three software platforms is not required. Strong Louisiana Medicaid/SUD billing knowledge and independent denial-resolution skills are our highest priorities.

Work Arrangement

This position is primarily office-based in the Mandeville/Covington area, with flexibility to work remotely 1–2 days per week. Additional onsite availability may be required during onboarding and the initial billing transition. Candidates must reside within reasonable commuting distance of the office.

Ideal Candidate

We are looking for someone who does more than submit claims. The ideal candidate is proactive, detail-oriented, dependable, and comfortable independently researching billing issues, identifying solutions, and following claims through resolution. This individual should be capable of managing assigned billing responsibilities with minimal supervision while maintaining consistent communication with the Revenue Cycle Manager. The Revenue Cycle Manager will retain oversight of revenue-cycle strategy, payer relationships, financial performance, compliance, and departmental operations.