What are the responsibilities and job description for the Billing Manager position at Substance Abuse Facility?
Position Overview
We are seeking an experienced Substance Abuse Billing Specialist with a strong focus on Out-of-Network (OON) behavioral health billing. The ideal candidate has hands-on experience managing the full revenue cycle for addiction treatment services and is highly proficient in CMD and Kipu EMR systems, payer portals, and complex reimbursement processes.
This role requires a detail-oriented professional who understands payer requirements, authorization processes, denials management, and OON reimbursement strategies within detox, residential, PHP, and IOP levels of care.
Key Responsibilities
- Manage the full revenue cycle for OON substance abuse claims
- Submit, track, and follow up on insurance claims via payer portals
- Verify benefits and document detailed OON reimbursement structures
- Review and interpret Explanation of Benefits (EOBs)
- Identify underpayments and submit corrected claims, reconsiderations, and appeals
- Monitor authorizations and ensure alignment with billed services
- Ensure claims meet payer-specific billing guidelines and documentation requirements
- Work inside CMD and Kipu EMR systems for charge entry, claim submission, and reporting
- Maintain accurate patient financial records and insurance documentation
- Track and trend denials and reimbursement patterns
- Communicate with insurance representatives to resolve claim discrepancies
- Maintain compliance with HIPAA and industry regulations
Required Qualifications
- 2 years of substance abuse / behavioral health billing experience
- Strong experience with OON claims processing
- Proficiency in CMD and Kipu
- Advanced knowledge of payer portals (e.g., Availity, Optum, UHC, BCBS portals, etc.)
- Ability to read and interpret EOBs and ERA reports
- Familiarity with payer requirements, medical necessity criteria, and authorization processes
- Experience managing appeals and denials
- Strong understanding of revenue cycle management
- Excellent attention to detail and organizational skills
Job Type: Full-time
Pay: $70,000.00 - $80,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Flexible schedule
- Health insurance
- Paid time off
- Vision insurance
- Work from home
Work Location: In person
Salary : $70,000 - $80,000