Drug Rehabilitation Billing Specialist Monsey NY 100k to 125k

Drug Rehabilitation Billing Specialist

Location: Monsey, NY

Job Type: Full-time

Salary: $100,000 $125,000 per year

About the Role

We are seeking an experienced Drug Rehabilitation Billing Specialist to manage the full revenue cycle for a growing behavioral health and substance use disorder organization.

This role is responsible for end-to-end commercial out-of-network (OON) billing across multiple levels of care, including detox, residential treatment, Partial Hospitalization Programs (PHP), and Intensive Outpatient Programs (IOP). The ideal candidate has strong experience with behavioral health billing, denial management, and maximizing reimbursement from commercial insurance carriers.

Responsibilities

• Manage the complete billing cycle for detox, residential, PHP, and IOP services.
• Submit and track commercial out-of-network claims from submission through payment.
• Monitor claim status and resolve rejected, pending, and denied claims.
• Investigate denials, prepare appeals, and coordinate with Utilization Review to obtain supporting clinical documentation.
• Post insurance payments and ERAs while identifying underpayments and reimbursement discrepancies.
• Reconcile payments against expected reimbursement schedules.
• Work closely with Utilization Review Directors, Patient Collections, and facility leadership to optimize revenue cycle performance.
• Maintain compliance with payer requirements and billing regulations.

Qualifications

• 25 years of hands-on substance use disorder billing experience required.

• Strong experience with commercial out-of-network (OON) behavioral health billing.

• Experience with the full revenue cycle, including claim submission, follow-up, denial management, appeals, payment posting, and collections.

• Working knowledge of UB-04 and CMS-1500 claim forms, revenue codes, HCPCS codes, modifiers, and place-of-service codes.

• Familiarity with commercial behavioral health payers including Optum Behavioral Health, Magellan, Evernorth, Carelon, and similar organizations.

• Understanding of single case agreements and OON reimbursement methodologies.

Preferred Qualifications

• Experience using EHRs, billing systems, and clearinghouses (Sunwave and Waystar experience is a plus).

• Inpatient substance use disorder billing experience.

• Experience billing facilities located in Florida or other highly regulated behavioral health markets.

• Knowledge of 42 CFR Part 2, HIPAA, and PHI handling requirements.

• Experience working for a multi-facility behavioral health provider or healthcare billing organization.

Benefits

• Competitive salary: $100,000 $125,000

• Comprehensive benefits package

• Stable, growing organization

• Opportunity for career advancement

• Collaborative leadership team

• Meaningful work supporting behavioral health and substance use disorder treatment programs

If you have a strong background in behavioral health revenue cycle management and are looking to join a growing organization, we'd love to hear from you.

Apply today!