Billing Specialist

Summary

The Billing Specialist I plays a key role in Spectrum's revenue cycle operations by ensuring timely and accurate billing, financial reporting, and payment posting. This position manages the full billing cycle, including claim submission, payment posting, denial follow-up, and productivity reporting. The Billing Specialist I works closely with the compliance, quality, and accounting teams to support an efficient and transparent revenue cycle process.

The ideal candidate has strong attention to detail, excellent customer service skills, and a solid understanding of insurance billing processes for Medicaid, Medicare, and Commercial payers.

• Prepare and submit accurate claims to Medicaid, Medicare, and Commercial payers.
• Post payments, denials, and daily deposits; reconcile to deposit logs.
• Research and resolve denied or rejected claims in accordance with payer guidelines.
• Prepare monthly summaries of charges, payments, and adjustments.
• Report provider productivity, including RVUs and incentive-based metrics.
• Facilitate provider credentialing and maintain payer rosters.
• Review documentation and address coding or billing issues with providers.
• File secondary and tertiary claims when needed (electronically or on paper).
• Respond to patient and payer billing inquiries in a timely and professional manner.
• Maintain confidentiality and compliance with HIPAA, Medicare, Medicaid, and SHG standards.
• Assist with audits, financial reports, and revenue cycle projects as assigned.
• Collaborate with other departments to support accurate and efficient billing operations.

Education & Experience

• High school diploma or GED required.
• Minimum of 1 year experience processing insurance claims, payments, and denials required.
• 2 years of experience in medical or mental health billing preferred.
• CMRS (Certified Medical Reimbursement Specialist) or CPB (Certified Professional Biller) preferred but not required.

Knowledge & Skills

• Working knowledge of ICD-10, CPT, and HCPCS coding standards.
• Familiarity with National Correct Coding Initiatives (NCCI).
• Proficiency with Microsoft Excel, Word, and email applications.
• Ability to analyze data and prepare clear, accurate reports.
• Strong attention to detail and organizational skills.
• Ability to meet monthly and yearly deadlines while managing multiple priorities.
• Excellent communication and customer service skills.
• Ethical, dependable, and committed to maintaining confidentiality.

• Meaningful work that directly supports your community.
• Collaborative and mission-focused team culture.
• Ongoing professional development and growth opportunities.
• Comprehensive benefits package (medical, dental, vision, retirement, PTO, and more).

Job Type: Full-time

• 401(k)
• 401(k) matching
• Employee assistance program
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Vision insurance

Work Location:

Hybrid remote in Phoenix, AZ 85029