Our acute adolescent care facility is seeking a dedicated Part-Time Weekends Billing and Utilization Review (UR) Specialist for up to 30 hours per week. This position is ideal for an experienced billing professional with strong knowledge of insurance and Medicaid billing, as well as experience with Utilization Review processes in a mental health or acute care setting. This role primarily supports weekend operations but may include flexible weekday hours as needed. The ideal candidate will be compassionate, detail-oriented, and proactive in helping patients and families navigate insurance, billing, and authorization processes.

QUALIFICATIONS

Education:

High school diploma/GED required. Associate degree or certification in medical billing, insurance coding, or health information management strongly preferred.

Training and Experience:

· Two to three years of experience in medical billing and coding, preferably in a behavioral health or acute care setting.

· Knowledge of Medicaid and insurance requirements for adolescent mental health services.

· Prior experience with Utilization Review processes (authorization requests, concurrent reviews, clinical documentation coordination) preferred.

· Excellent customer service skills and phone manner.

· Strong time management and organizational skills.

· Must possess a current certificate for CPR and first aid.

ACCOUNTABILITIES/DUTIES

Billing Responsibilities:

Submit reimbursement requests to Medicare, Medicaid, and private insurance. Accurately process insurance claims, enter charges, and post payments in a timely manner.

Follow up on payer denials, re-submit claims, and resolve billing discrepancies.

Work with patients and families to develop self-pay arrangements and payment plans.

Initiate private pay collections as needed.

Maintain accurate and confidential billing documentation.

Utilization Review Responsibilities:

Submit and track prior authorizations for treatment services. Coordinate and conduct concurrent reviews with insurance companies. Ensure that clinical documentation supports medical necessity. Communicate authorization updates to treatment teams. Assist in tracking length of stay and discharge planning from a payer perspective. Document all UR activities accurately and timely.

· This position requires availability on weekends and may include some flexible weekday hours.

· The candidate must be able to work independently with minimal supervision, maintaining confidentiality and professionalism at all times.

· Must have reliable transportation and the ability to work on-site.