Colorado River Behavioral Health System, LLC
Transitional Living Center Recovery & Turtle Bay Café Job Description
POSITION TITLE: myEvolv Billing specialist
HOURS OF WORK: As negotiated.
SUMMARY OF POSITION: Colorado River Behavioral Health System (CRBHS) is seeking an experienced MyEvolv Billing Specialist to oversee behavioral health billing operations, claims management, and electronic health record integrity. The ideal candidate will have extensive hands-on experience using Netsmart MyEvolv in an AHCCCS-funded behavioral health environment and possess a thorough understanding of Arizona Medicaid billing requirements.
RESPONSIBILITIES:
- Manage the complete behavioral health billing cycle within the Netsmart MyEvolv electronic health record system.
- Prepare, review, submit, and reconcile professional and institutional claims to AHCCCS and contracted Managed Care Organizations (MCOs).
- Investigate, correct, and resolve billing edits, claim rejections, denials, and payment discrepancies.
- Submit corrected claims, adjustments, and appeals while ensuring timely reimbursement.
- Monitor accounts receivable and follow up on outstanding claims.
- Collaborate with the CEO, Executive Director, clinical staff, and finance department to ensure documentation supports compliant billing.
- Review encounters for billing accuracy, medical necessity, coding, modifiers, provider setup, and payer-specific requirements.
- Maintain accurate member demographic, insurance, and provider information within MyEvolv.
- Work with the IT and EHR teams to identify, troubleshoot, and correct MyEvolv configuration issues that impact billing or documentation.
- Assist with MyEvolv billing workflows, testing, system enhancements, and implementation of new billing processes.
- Participate in Coordination of Care meetings to ensure services are documented appropriately for reimbursement.
- Maintain knowledge of AHCCCS policies, managed care organization requirements, CPT/HCPCS coding, modifiers, and behavioral health billing regulations.
- Respond to payer audits, internal audits, and documentation requests.
- Review records and prepare documentation for annual audits and regulatory reviews.
- Provide administrative oversight and guidance to the documentation team regarding billing compliance and documentation requirements.
- Perform additional billing, compliance, and revenue cycle duties as assigned.
QUALIFICATIONS:
- Minimum of three (3) years of recent, hands-on experience using Netsmart MyEvolv. This is a required qualification.
- Strong organizational skills with excellent attention to detail.
- Ability to manage multiple priorities while meeting deadlines.
- Able to function as a member of the management team.
- Minimum age of 21 years.
COMMITMENT TO DIVERSITY: TLCR/TBC is committed to creating a diverse and inclusive environment. We welcome candidates who bring diverse perspectives and experiences to join our team, contributing to the growth and innovation of our services.
Pay: $24.53 - $26.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Health insurance
- Retirement plan
People with a criminal record are encouraged to apply
Application Question(s):
- Do you have 3 years of experience in myEvolv EHR system?
Work Location: Remote
