Trilogy Wellness LLC

Our mission is to bring the highest quality of care to those individuals suffering from Opioid Use Disorder (OUD). We understand not only how difficult it can be to recover from addiction but that the road to recovery may be a long and bumpy one. And we know for sure that to achieve success, this road must be traveled with as much support as possible.
About The Role
The BH Billing Specialist is a key member of our Revenue Cycle Management (RCM) team, responsible for end-to-end behavioral health billing and credentialing activities. In this hourly, full-time role, you will manage payer contracting, provider and location credentialing, insurance and benefits verification, prior authorizations, claims submission, and accounts receivable follow-up. You will work closely with clinical and administrative staff to ensure accurate, timely reimbursement and a smooth financial experience for both patients and providers within a behavioral health setting.
What You'll Do
<ul>
<li>Manage behavioral health payer contracting processes for the organization, including completing applications, updating contracts, and maintaining payer records</li>
<li>Credential and re-credential behavioral health providers and locations with commercial and government payers, ensuring all requirements and deadlines are met</li>
<li>Verify patient insurance coverage and behavioral health benefits prior to services, documenting eligibility, copays, coinsurance, deductibles, and visit limits</li>
<li>Obtain, track, and renew prior authorizations for behavioral health services, ensuring accurate clinical information and timely approvals</li>
<li>Prepare, review, and submit clean behavioral health claims (electronic and paper) to payers in accordance with payer-specific billing rules and timelines</li>
<li>Monitor and manage accounts receivable (AR), including identifying outstanding claims, aged balances, and underpayments</li>
<li>Conduct proactive follow-ups on unpaid, denied, or rejected claims; work denials and appeals to resolution to maximize reimbursement</li>
<li>Post payments and adjustments from payers and patients accurately and promptly, reconciling against remittance advices and EOBs</li>
<li>Identify and correct billing errors, trends, or documentation issues that impact claim acceptance or payment</li>
<li>Communicate with payers, patients, and internal teams to resolve billing, coverage, and authorization issues</li>
<li>Maintain up-to-date knowledge of behavioral health billing, credentialing, and payer policies, including coverage and authorization requirements</li>
<li>Document all billing, credentialing, verification, and follow-up activities in the practice management and/or EHR systems</li>
<li>Support revenue cycle process improvements and help implement best practices for behavioral health RCM</li>
</ul>
Qualifications
<ul>
<li>Minimum of 2 years of experience in medical billing with a focus on behavioral health billing</li>
<li>Hands-on experience with behavioral health payer contracting and credentialing for providers and locations</li>
<li>Demonstrated experience in revenue cycle management (RCM), including claims submission, AR follow-up, and collections</li>
<li>Proficiency in insurance verification, coverage and benefits verification, and prior authorization workflows for behavioral health services</li>
<li>Strong understanding of behavioral health billing requirements, payer rules, and common denial reasons</li>
<li>Experience using practice management and/or EHR systems for billing, claims, and credentialing workflows</li>
<li>Ability to interpret EOBs/ERAs, payer remittances, and resolve discrepancies or underpayments</li>
<li>High attention to detail, accuracy, and organization in managing multiple payers, providers, and deadlines</li>
<li>Strong written and verbal communication skills, with the ability to interact professionally with payers, patients, and internal teams</li>
<li>Proven ability to work independently in a fast-paced environment while meeting productivity and quality standards</li>
<li>Familiarity with HIPAA regulations and maintaining confidentiality of patient and practice information</li>
</ul>

BH Billing

BH Billing

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