Outpatient Behavioral Health Billing & Administrative Specialist

The Outpatient Behavioral Health Billing & Administrative Specialist (Part Time) manages billing and revenue cycle operations for substance use disorder (SUD) and mental health outpatient services. This role supports clinic administration and serves as backup for human resources and payroll functions. The position requires knowledge of behavioral health documentation, payer requirements (including Medicaid(, and confidentiality standards, along with strong organizational and multitasking skills.

Responsibilities

Behavioral Health & Billing Revenue Cycle

• Submit and manage claims for outpatient SUD and mental health services, including individual, group, IOP, and other program services
• Ensure accurate use of CPT, HCPCS, and ICD-10 codes specific to behavioral health and SUD treatment
• Verify insurance eligibility, benefits, prior authorizations, and service limits (with strong emphasis on Medicaid and managed care plans)
• Monitor accounts receivable and aggressively follow up on denied, rejected, or unpaid claims
• Post payments, adjustments, and reconcile billing discrepancies
• Ensure compliance with payer requirements, state regulations, and documentation standards
• Collaborate with clinical staff to ensure documentation supports medical necessity and billing compliance
• Generate financial and billing reports; assist with audits and regulatory reviews

Administrative & Clinic Operations Support

• Maintain accurate client records in EHR systems, ensuring alignment with confidentiality requirements (including 42 CFR Part 2 and HIPAA)
• Support client intake, scheduling, and coordination of outpatient services
• Assist with tracking census, service utilization, and program metrics (e.g., ASAM level of care tracking such as 1.0 outpatient and 2.1 IOP)
• Perform general administrative duties including data entry, document management, and correspondence
• Support leadership with operational reporting and compliance documentation
• Backup administrative support to the Board of Directors and Executive Director as needed

Human Resources & Payroll Backup Duties - see full job posting

Qualifications

• Associate’s or Bachelor’s degree in Healthcare Administration, Business, Accounting, or related field (or equivalent experience)
• 2-4 years of experience in medical billing, with preference for behavioral health or substance use disorder settings
• Strong knowledge of Medicaid billing, managed care, and behavioral health payer requirements
• Familiarity with ASAM levels of care and documentation requirements for SUD treatment preferred
• Experience with EHR and billing systems used in behavioral health settings
• Working knowledge of HIPAA and 42 CFR Part 2 confidentiality regulations
• Familiarity with HRIS and payroll systems preferred
• Strong attention to detail, organization, and ability to manage multiple priorities
• Effective communication skills and ability to work collaboratively with clinical and administrative staff

Visit our website for full job posting: https://kinnicfalls.org/contact/#careers