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Medical Billing Specialist
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Position Summary (in person)
Special Service for Groups (SSG), a nonprofit mental health organization, is seeking a detail-oriented Denials Specialist to join our Internal Systems team. This role ensures denied claims are resolved efficiently, directly supporting access to care for vulnerable communities and strengthening the financial health of our programs. The ideal candidate is persistent, analytical, and motivated to improve billing outcomes through thorough investigation and resolution of claim issues.
Key Responsibilities
Claims Management
- Review and analyze denied claims from LACDMH and other payers to identify root causes and resolution strategies
- Prepare and submit appeals, corrections, and resubmissions in accordance with LACDMH and Medi-Cal guidelines
- Track and report on remittance advice and payer-specific denial patterns
- Maintain accurate records of denial activity, appeal outcomes, and payer correspondence
Collaboration & Communication
- Work closely with clinical and administrative teams to gather necessary documentation
- Respond to documentation requests from payers and ensure timely follow-up
- Provide excellent customer service and resolve billing-related inquiries professionally
Compliance & Reporting
- Monitor denial trends and provide feedback to improve front-end processes
- Ensure compliance with HIPAA and all federal, state, and local billing regulations
- Support QA efforts by assisting with documentation reviews and compliance tracking
- Participate in staff meetings, trainings, and special projects as assigned
Required Skills
- Excellent written and verbal communication skills
- Strong analytical and problem-solving abilities
- Ability to manage multiple priorities in a fast-paced environment
- Proficiency in Microsoft Excel or data analysis tools
- Knowledge of HIPAA and healthcare compliance regulations
Qualifications
- 2–3 years of experience in behavioral health billing, with direct experience handling LACDMH claims and denials preferred
- Strong understanding of Medi-Cal, CPT/HCPCS codes, and LACDMH claiming procedures
- Proficiency in electronic health records (EHR) and billing platforms (e.g., IBHIS, Avatar, or similar)
Education
- Bachelor's Degree in Business, Healthcare Administration, Public Health, or a related field (required or equivalent experience considered)
- Certified Professional Biller (CPB) through AAPC or equivalent nationally recognized billing certification preferred
Why Join Us?
At SSG, we believe that every claim resolved helps ensure our clients receive the care they deserve. Join a team that values persistence, accuracy, and a shared commitment to equity and access in behavioral health.
Job Type: Full-time
Pay: $ $30.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Ability to Commute:
- Los Angeles, CA Required)
Work Location: In person
