Senior Medical Billing Specialist

South Point Counseling Services (SPCS) is an established and growing outpatient behavioral health practice serving individuals, couples, children, and families throughout Utah. Our multidisciplinary team provides mental health counseling, psychological assessments, psychiatric medication management, and specialized behavioral health services.

We are seeking an experienced, highly organized, and dependable Senior Medical Billing Specialist to help lead our billing operations, support our billing team, and ensure accurate and timely reimbursement for services provided.

• Submit electronic and paper insurance claims and accurately post/adjust payments from Electronic Remittance Advice (ERA) reports.
• Monitor electronic claim submissions, rejections, denials, and payment discrepancies.
• Investigate and resolve complex insurance billing issues.
• Follow up on outstanding insurance claims and accounts receivable.
• Submit corrected claims, reconsiderations, and appeals as necessary.
• Monitor insurance and patient aging reports.
• Oversee and improve collection processes to reduce outstanding insurance/patient accounts receivable.
• Review payment posting, adjustments, and insurance reimbursements for accuracy.
• Ensure compliance with payer requirements, billing regulations, and company policies.

• Provide day-to-day guidance and support to billing staff.
• Train new billing employees on billing procedures, insurance requirements, and practice management systems.
• Monitor workflow, identify problems, and recommend process improvements.
• Review, update, and enhance the Billing Tasks Statement of Policy to ensure accuracy, consistency, and alignment with current billing procedures and regulatory requirements.
• Communicate billing concerns and operational updates to management.

• Communicate with insurance companies regarding claims, eligibility, benefits, and reimbursement issues.
• Assist with resolving patient balances and payment discrepancies.
• Coordinate with clinical and administrative staff to resolve billing-related issues.
• Provide exceptional customer service, including professionally handling difficult conversations, resolving patient complaints, and assisting upset or frustrated clients with patience, empathy, and respect.

• Conduct annual quality assurance reviews by sampling and auditing patient accounts to verify compliance with Optum Medicaid requirements, including OQ and MHER standards.
• Prepare regular reports on collections, outstanding claims, denials, and accounts receivable.
• Identify recurring billing errors and recommend corrective actions.
• Monitor billing performance and support the financial health of the practice.
• Maintain confidentiality and comply with HIPAA requirements.

• Minimum of 5 years of medical billing experience.
• Strong knowledge of insurance claims processing, denials, appeals, payment posting, and accounts receivable.
• Experience working with commercial insurance, Medicaid, and Medicare.
• Demonstrated ability to independently resolve complex billing issues.
• Excellent organizational, analytical, and problem-solving skills.
• Strong communication and customer service skills.
• Ability to prioritize responsibilities and meet deadlines.
• High level of accuracy, professionalism, and accountability.
• Experience training or mentoring billing staff.

• Experience in outpatient mental health or behavioral health billing.
• Proficiency in using Therapy Notes , Optum Provider Connect NX , and Utah Medicaid PRISM .
• Familiarity with Utah Medicaid, Optum Medicaid, Medicare, Select Health, and other behavioral health insurance payers.
• Exp…