Lead Billing Collections Specialist (South Pasadena)

Lead Billing Collections Specialist (South Pasadena)

Who We Are:

We are a premier provider dedicated to healing children and young adults, strengthening families, and transforming communities through quality, comprehensive services and advocacy. We envision a world in which children and young adults, families, and communities are able to heal, grow, and thrive.

Job Type: Full-Time, Non-exempt Opportunity

Starting Salary Range: $29.00 - $33.00 per hour (based on experience)

What We Offer:

An outstanding benefits package and numerous opportunities for career growth and advancement within our organization!

• 13 Paid Holidays per year including Juneteenth
• Earn up to 16 days of paid vacation time, plus 50 hours of paid sick leave annually.
• 401(k) with no wait period and no vesting schedule
• 401(k) matching up to 4%
• Medical insurance offering 3 HMO with Kaiser and Health Net, and also a PPO Plan
• The Difference Card- Employer-funded benefit that works alongside an employee's health insurance plan to help offset out-of-pocket costs like copays, deductibles, and coinsurance.
• Dental insurance both HMO & PPO options, with 100% employer paid for HMO employee only coverage plan
• Vision insurance offers 100% employer-paid vision plan through EyeMed for you and your entire family
• Life and AD&D insurance 100% employer paid up to two times the annual salary
• Long Term Disability
• Flexible Spending Account for Medical and Dependent Care
• Employee Assistance Program
• This role is eligible for Public Service Loan Forgiveness (PSLF)

ESSENTIAL FUNCTIONS:

The Lead Billing Collection Specialist is responsible for ensuring accurate, timely, and compliant submission of mental and behavioral health claims to the Los Angeles County Department of Mental Health (DMH), Medi-Cal, and third-party payers. This role serves as a subject matter expert in mental and behavioral health billing, supporting revenue integrity through claim review, denial management, reporting, and collaboration with clinical and quality teams. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.

The essential functions include:

• Manage all aspects of billing and collections for multiple insurance payers, ensuring precise charge entry and prompt claim submission
• Maintain solid understanding of mental and behavioral health billing, DMH systems, and third-party requirements
• Maintain a current understanding of CPT, ICD-10, HCPCS codes, DMH guidelines, and billing rules specific to each payer
• Review, verify, and confirm the accuracy and completeness of billing records prior to claim submission, ensuring prior authorizations and concurrent reviews
• Identify, track, and resolve denied, voided, and unpaid claims through follow-up and appeals
• Review, prepare, and submit higher-level appeals with supporting documents
• Analyze denial trends and notify leadership of systemic issues or payer patterns
• Monitor clearinghouse rejections and billing errors, implement corrective actions to prevent recurrence
• Support reduction of outstanding accounts receivable (A/R) and ensure accurate payment postings
• Perform data tracking and reconciliation across DMH/IBHIS, Welligent, and related systems
• Serve as a subject-matter resource for billing questions, complex cases, and workflow improvements
• Train, mentor, and onboard new team members
• Exhibit strong critical thinking, effective problem-solving abilities, and attention to detail.
• Exceptional customer service with strong verbal and written communication skills
• Ability to manage multiple priorities, meet deadlines, and work independently
• Other duties as required

EDUCATION, EXPERIENCE and CERTIFICATES

• 3 to 5+ years' experience in Medical Billing
• 2+ years of experience in behavioral/mental health billing strongly preferred
• Experience supervising or leading a billing team preferred
• High School Diploma or equivalent required
• Prior experience with Welligent or similar EHR systems preferred

TRAUMA INFORMED CARE (TIC)

Hillsides practices Trauma Informed Care (TIC) principles which recognizes the signs, symptoms, and widespread impact of trauma; Employees are asked to comprehensively integrate knowledge of Trauma Informed Care into policies, procedures, and practices with the goal to prevent re-traumatization which promotes healing of families, youth, individuals, and communities.

Hillsides is an Equal Opportunity Employer

We welcome applicants from all backgrounds and do not discriminate based on any legally protected characteristic, including race, color, religion, sex, gender identity or expression, sexual orientation, national origin, ancestry, disability, medical condition, age, veteran or military status, or marital status, in accordance with applicable federal, state, and local laws. We are committed to providing reasonable accommodation(s) for individuals with disabilities throughout the application and employment process.