Prior Authorization Utilization Review Jobs in Alabama

Bradford Health Services provides addiction treatment programs, resources, and community for every aspect of recovery. Through our premier drug and alcohol rehab facilities across the Southeast, we provide affordable, evidence-based addiction treatment with proven outcomes at every level of care. We’re guided by unity and dedicated to meeting and treating every patient right where they are. Bradford is more than a healthcare network; we are recovery communities for every stage of the journey.

We are seeking a Billing Specialist to add to our dynamic team. The Billing Specialist is responsible for ensuring accurate and timely submission of claims to third-party payers. This position plays a critical role in the revenue cycle by reviewing patient accounts, resolving charge errors and billing warnings, validating claim information, and ensuring claims meet payer and regulatory requirements prior to submission. The ideal candidate will possess strong healthcare billing experience, exceptional attention to detail, and the ability to independently research and resolve billing issues. The Billing Specialist will work collaboratively with clinical, operational, utilization review, and revenue cycle teams to identify and correct issues that may delay or prevent successful claim submission.

Responsibilities

• Review patient accounts and billing work queues to ensure claims are generated and submitted accurately and in a timely manner
• Research and resolve charge errors, billing edits, claim warnings, and other system-generated exceptions preventing claims from being released
• Validate charges for accuracy, completeness, and appropriate dates of service prior to claim submission
• Review claims for appropriate revenue codes, HCPCS/CPT codes, modifiers, bill types, and other required billing elements, as applicable
• Ensure claims are submitted in accordance with payer-specific, contractual, and regulatory billing requirements
• Identify missing, incomplete, or inconsistent information that may result in claim rejection or denial and coordinate resolution prior to billing
• Research patient accounts, authorization information, eligibility, payer requirements, and supporting documentation when necessary to resolve billing issues
• Monitor unbilled accounts and billing work queues to identify and address barriers to timely claim submission
• Maintain established billing productivity and quality standards while prioritizing accuracy and clean-claim submission
• Review rejected claims and clearinghouse edits and make appropriate corrections for timely resubmission
• Identify recurring billing or charge capture issues and escalate trends to leadership for process improvement
• Collaborate with Utilization Review, Patient Financial Services, clinical teams, facility operations, and other Revenue Cycle departments to resolve account discrepancies
• Maintain thorough and accurate account documentation regarding billing actions and issue resolution
• Protect patient confidentiality and maintain compliance with HIPAA and organizational policies
• Remain current on payer billing requirements and changes that may impact claim submission
• Assist with special billing projects, account reviews, audits, and other revenue cycle initiatives as assigned
• Exceptional attention to detail and commitment to billing accuracy
• Strong understanding of the healthcare revenue cycle and the relationship between charge capture, authorization, billing, and reimbursement
• Ability to independently research complex account issues and determine appropriate resolution
• Ability to recognize potential billing errors before claims are submitted
• Strong organizational and time-management skills
• Ability to work effectively in a high-volume, deadline-driven environment
• Ability to identify trends and distinguish isolated account issues from broader process or system problems
• Strong sense of accountability and ownership for assigned accounts and work queues
• Ability to collaborate effectively across departments and communicate billing issues clearly and professionally