What are the responsibilities and job description for the Denials Specialist position at SPECIAL SERVICE FOR GROUPS?
Position Summary (in person)Special Service for Groups (SSG), a nonprofit mental health organization, is seeking a detail-oriented Denials Specialist to join our Internal Systems team. This role ensures denied claims are resolved efficiently, directly supporting access to care for vulnerable communities and strengthening the financial health of our programs. The ideal candidate is persistent, analytical, and motivated to improve billing outcomes through thorough investigation and resolution of claim issues.Key ResponsibilitiesClaims ManagementReview and analyze denied claims from LACDMH and other payers to identify root causes and resolution strategiesPrepare and submit appeals, corrections, and resubmissions in accordance with LACDMH and Medi-Cal guidelinesTrack and report on remittance advice and payer-specific denial patternsMaintain accurate records of denial activity, appeal outcomes, and payer correspondenceCollaboration & CommunicationWork closely with clinical and administrative teams to gather necessary documentationRespond to documentation requests from payers and ensure timely follow-upProvide excellent customer service and resolve billing-related inquiries professionallyCompliance & ReportingMonitor denial trends and provide feedback to improve front-end processesEnsure compliance with HIPAA and all federal, state, and local billing regulationsSupport QA efforts by assisting with documentation reviews and compliance trackingParticipate in staff meetings, trainings, and special projects as assignedRequired SkillsExcellent written and verbal communication skillsStrong analytical and problem-solving abilitiesAbility to manage multiple priorities in a fast-paced environmentProficiency in Microsoft Excel or data analysis toolsKnowledge of HIPAA and healthcare compliance regulationsQualifications2–3 years of experience in behavioral health billing, with direct experience handling LACDMH claims and denials preferredStrong understanding of Medi-Cal, CPT/HCPCS codes, and LACDMH claiming proceduresProficiency in electronic health records (EHR) and billing platforms (e.g., IBHIS, Avatar, or similar)EducationBachelor’s Degree in Business, Healthcare Administration, Public Health, or a related field (required or equivalent experience considered)Certified Professional Biller (CPB) through AAPC or equivalent nationally recognized billing certification preferredWhy Join Us?At SSG, we believe that every claim resolved helps ensure our clients receive the care they deserve. Join a team that values persistence, accuracy, and a shared commitment to equity and access in behavioral health.Job Type: Full-timeBenefits:401(k)Dental insuranceEmployee assistance programFlexible spending accountHealth insuranceLife insurancePaid time offVision insuranceAbility to Commute:Cerritos, CA (required)Work Location: In personCompany DescriptionSpecial Service for Groups, Inc. – better known as SSG – is a non-profit health and human service organization dedicated to building and sustaining community-based programs that address the needs of vulnerable communities. Special Service for Groups (SSG) is a non-profit organization dedicated to provide community-based solutions to the social and economic issues facing those in greatest need. SSG has evolved into a model organization designed to provide services for diverse groups with maximum efficiency and impact. This is achieved by developing and managing programs which serve our many communities by encouraging their involvement and self-sufficiency. SSG believes that the needs of groups and individuals cross traditional ethnic, racial and other cultural boundaries. SSG serves as a bridge between people with common needs to identify ways to pool resources for the greater good of all.
Salary : $23 - $30