Billing Specialist - SUD Treatment

Job Description

Job Description

Salary : $26 - $30 / Hour

BILLING SPECIALIST

SUBSTANCE USE DISORDER TREATMENT

CRI-Help is a substance use disorder treatment center with several locations across Los Angeles County. We've been around since 1971 and are noted as an organization practicing integrity in our commitment to ethical and meaningful client care. Our mission is to improve the welfare of the community by providing first-class substance use disorder treatment to adults and families seeking freedom from the bondage of addiction, and we live out that mission everyday with our staff and clients.

As a nonprofit organization, CRI-Help is a qualifying employer affording our full-time employees the opportunity to begin, or continue, the process of seeking PSLF (Public Service Loan Forgiveness). In addition, our benefits package for full-time employees is quite robust- especially the option for 100% employer-paid $0 deductible Platinum plan Medical insurance, including an additional 40% paid coverage for dependents, which accompanies our 401k with 4% match option nicely. Please see the full list of benefits below, especially the 12 paid holidays per year (we are a 24 / 7 facility, so not all employees will be able to take all 12 paid holidays off- but will still get paid for the holiday in addition to their hours worked).

CRI-Help is an amazing organization to be a part of and I strongly encourage you to consider joining the team! We opened a new facility in Lincoln Heights in January 2025 and are still hiring for all roles- keep referring back to https : / / crihelp.bamboohr.com / careers / for current openings at all sites.

The Billing Specialist is responsible for preparing, reviewing, and submitting accurate billing claims for services provided. This role ensures all billing records are correct, follows up on denied or unpaid claims, and works with internal teams and external agencies to resolve any issues. The billing specialist also stays updated on billing guidelines and uses electronic health record systems to support timely and compliant billing.

Duties and Responsibilities :

• Review and reconcile billing records daily to ensure accuracy, including patient authorizations, financial eligibility, diagnoses, and applicable modifiers.
• Download and analyze the Billable Client Service Report daily to validate billing data; identify and communicate any discrepancies requiring correction.
• Conduct monthly audits of all billable claims, ensuring all billing information meets compliance and payer requirements.
• Submit accurate billing to appropriate agencies monthly and ensure timely follow-up on outstanding or denied claims.
• Collaborate with the Billing Supervisor to resolve audit findings, discrepancies, and claim denials in a timely and professional manner.
• Work closely with local and state agencies to address and resolve claim denials, reimbursement issues, or documentation deficiencies.
• Maintain the Admissions worksheet daily to reflect new admissions, discharges, and relevant patient status updates.
• Monitor and identify missing or delayed authorization requests or extensions for patient admissions, ensuring all necessary documentation is submitted promptly.
• Collaborate with the Clinical Department to verify timely completion and documentation of all non-billable and billable services.
• Review group counseling and patient education session logs (e.g., CRI-Helps group sign-in sheets) to confirm that client participation is accurately recorded and reflected in internal tracking systems.
• Maintain working proficiency in SAPCs PCNX and MyEvolv electronic health record systems; navigate and utilize both platforms effectively for billing-related activities.
• Maintain up-to-date knowledge of and compliance with local, state, and federal billing guidelines, including Title 22, Title 9, and the SAPC DMC Provider Manual.

Skills / Knowledge

Education / Training

Experience

Working Conditions

Special Conditions

Position Reports To

Pay Range

Position Type

Benefits