Insurance Billing Operations Specialist

Job Summary

As a full-time Insurance Billing Operations Specialist, the successful candidate will oversee the end-to-end claims lifecycle, ensuring accurate and timely billing for patients while working remotely with the Revenue Cycle Management team to manage insurance claim denials and rejections.

Key responsibilities

• Oversee the end-to-end claims lifecycle from submission to reimbursement, resolving claim holds and re-submitting or appealing denials
• Resolve behavioral health claim denials related to coverage issues, prior authorization, and documentation
• Investigate insurance claim denials and communicate with payers or patients as necessary to resolve issues

Required qualifications

• 1+ years of insurance claims management experience in behavioral health
• Experience making payer calls and investigating claim denials
• Familiarity with practice management software such as Healthie and Candid Health is a plus
• Strong organizational skills for tracking follow-ups and escalations
• Ability to process 30+ claims per day accurately and efficiently