Vive Adolescent Care ยท 1 week ago
Billing & UR Specialist
St George, UT
Full-time
Onsite
Entry, Mid Level
$24/hr - $27/hr
2+ years expVive Adolescent Care is an acute adolescent care facility seeking a dedicated Billing and Utilization Review (UR) Specialist. The role involves managing billing processes, insurance claims, and utilization reviews in a mental health setting, ensuring that patients and families receive the necessary support in navigating these processes.
Hospital & Health Care
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
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
Qualification
Required
High school diploma/GED
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
Excellent customer service skills and phone manner
Strong time management and organizational skills
Must possess a current certificate for CPR and first aid
History with billing AR
Availability on weekdays and may include some flexible weekend hours
Ability to work independently with minimal supervision, maintaining confidentiality and professionalism at all times
Reliable transportation and the ability to work on-site
Preferred
Associate degree or certification in medical billing, insurance coding, or health information management
Prior experience with Utilization Review processes (authorization requests, concurrent reviews, clinical documentation coordination)
Company
Vive Adolescent Care
Vive Adolescent Care is an insurance based treatment facility for teens in crisis, and their families.
11-50 employees
Funding
Current Stage
Early StageCompany data provided by crunchbase