Billing Specialist

Summary

RethinkFirst provides behavioral health solutions and billing services that support individuals, families, providers, employers, and payors. The RCM Billing Specialist supports billing teams by submitting clean claims, resolving billing issues, and working with insurance companies to ensure timely reimbursement for therapy sessions.

Responsibilities

• Ensure strict HIPAA-compliant confidentiality with all client data and claims
• Manage and operate in multiple different billing platforms dependent on client needs which could include Azalea, Tebra, Central Reach and/or Rethink Integrated Billing Module
• Manage assigned client accounts billing scrubs for primary and secondary claims
• Submit claims electronically for primary and secondary payors
• Solve clearinghouse rejections
• Submit corrected claims for billing errors, rebill projects (new plans/new year, new information on payor policies)
• Maintain account spreadsheets, billing cheat sheets, provider, and billing information including provider roster and payer policy billing rules
• Contribute to updates and communicate to Customer Billing Advocate and other members of POD
• Provide internal reporting to team of status and issues for clients within POD
• Meet internal benchmarks for clean claims / first pass rate, unbilled claims, clearinghouse rejections, secondary claims, and denials for billing errors
• Research specific payor billing rules as needed
• Review client billing documentation to ensure claims are submitted based on payor requirements
• Stay informed about Payor and Industry Billing rules
• Foster a positive work environment for team members

Skills

• • 1-2 years of billing experience in speech, occupational, and ABA therapy
• • Strong knowledge of CPT coding and billing rules for major health insurance companies
• • Experience working directly with large insurance companies such as Blue Cross Blue Shield, Cigna, Magellan, etc
• • Proficiently using Billing Software and Clearinghouse systems (Azalea, Kareo, Waystar, TriZetto, Azalea, Central Reach)
• • Proficient using Microsoft Suite (Outlook, Excel, Word)
• • Minimum 1-2 years' experience working in an office setting
• • Minimum 1 year experience in billing both major commercial insurance companies as well as state Medicaid programs
• • Experience using insurance company websites/portals
• • Proficient using Microsoft Suite (Outlook, Excel, Word)
• • HS Diploma or Equivalent required
• • Full-time, Hourly, Monday-Friday (9-6 PM)
• • Remote opportunities are available only in the following states: AL, AR, AZ, CA, CO, FL, GA, ID, IL, IN, IA, MO, NC, NE, NY, OH, PA, SC, TN, TX, UT, VA
• • Previous ABA, Speech, OT, and Mental Health billing experience
• • Bachelor's degree preferred

Qualifications

Must Haves

• • 1-2 years of billing experience in speech, occupational, and ABA therapy
• • Strong knowledge of CPT coding and billing rules for major health insurance companies
• • Experience working directly with large insurance companies such as Blue Cross Blue Shield, Cigna, Magellan, etc
• • Proficiently using Billing Software and Clearinghouse systems (Azalea, Kareo, Waystar, TriZetto, Azalea, Central Reach)
• • Proficient using Microsoft Suite (Outlook, Excel, Word)
• • Minimum 1-2 years' experience working in an office setting
• • Minimum 1 year experience in billing both major commercial insurance companies as well as state Medicaid programs
• • Experience using insurance company websites/portals
• • Proficient using Microsoft Suite (Outlook, Excel, Word)
• • HS Diploma or Equivalent required
• • Full-time, Hourly, Monday-Friday (9-6 PM)
• • Remote opportunities are available only in the following states: AL, AR, AZ, CA, CO, FL, GA, ID, IL, IN, IA, MO, NC, NE, NY, OH, PA, SC, TN, TX, UT, VA

Nice to Haves

• • Previous ABA, Speech, OT, and Mental Health billing experience
• • Bachelor's degree preferred

Benefits

• PTO and Vacation Days after a 90-day introductory period
• Paid Holidays
• Generous Health, Denial & Vision benefits package
• 401k + Matching
• Remote opportunities are available only in the following states: AL, AR, AZ, CA, CO, FL, GA, ID, IL, IN, IA, MO, NC, NE, NY, OH, PA, SC, TN, TX, UT, VA