Claims Specialist - Therapy and Beyond

Therapy & Beyond is one of the largest BCBA-owned ABA organizations, founded and led by Dr. Regina Crone, BCBA-D, since 2006. At Therapy & Beyond, we approach the needs of each patient both individually and as part of a dynamic interdisciplinary team working with experts in Applied Behavior Analysis (ABA) therapy, Speech-Language Pathology, and  Occupational Therapy. We love helping individuals reach their full potential by supporting not only the patient but also their family.  Above all, we grow potential by putting people first, doing our best together, and making therapy fun! 

The Claims Specialist position is responsible for submitting claims of patient accounts. This is accomplished through the collection, posting, and management of patient payments.  In addition, the position will also be responsible for submitting claims, tracking remits, and following up with insurance payers as required.  The Claims Specialist will work very closely with multiple departments to ensure communication among the various parties ensuring all are aware of ongoing developments.  

JOB SPECIFIC FUNCTIONS:

• Filter in CR by clinic location/date to pull all patients you will bill for that day
• Verify the time, location, and insurance authorization of each claim
• Hold claims for any patients that we have a temporary authorization for
• Hold claims for any patient that changed insurance and we are waiting on new authorization approval
• Communicate with clinics on any billing entries that need to be changed, corrected, or clarified
• Ensure on all claims the correct billing information is selected(provider, clinic, etc.,)
• Send all claims to Gateway
• Check that appropriate modifiers are selected when applicable

• Education: High School Diploma or GED required. An associate, bachelor’s degree (or in progress), or applicable experience in a related field such as billing, account reconciliation, collections or other healthcare revenue cycle environment preferred.
• Experience: 2 years of experience working in a healthcare revenue cycle environment/billing preferred
• Knowledge of medical billing/coding.  
• Knowledge of electronic practice management systems.
• Knowledge of business office procedures and the ability to operate a multi-line phone system. Ability to establish and maintain effective working relationships with patients, employees, and the public. Organized and detail-oriented.

Ray rate: $18-$22 per hour

Status: Full time, non-exempt