Behavioral Health Claims Specialist

5 days ago


Prescott, Arizona, United States Billing Solutions Full time
Job Title: Behavioral Health Claims RepresentativeJob Summary

We are seeking a highly skilled Behavioral Health Claims Representative to join our team at Billing Solutions. As a key member of our team, you will be responsible for researching and documenting denials, analyzing denied claim explanations, and composing correspondence to insurance carriers.

Key Responsibilities
  • Research and document denials in a thorough and professional manner.
  • Analyze denied claim explanations, insurance carrier contacts, and general correspondence from insurance companies.
  • Request medical records from internal staff when needed.
  • Compose correspondence in accordance with regulatory requirements.
  • Maintain tracking systems and organized files for all appeals.
  • Monitor appeals to ensure timely completion and regulatory compliance.
  • Act as a point of contact for submission and resolution of denial determinations.
  • Collect and analyze data regarding denial determinations and appeals.
  • Develop policies and procedures for appeals and quality assurance measures.
Requirements
  • Experience appealing denied insurance claims for out-of-network providers (preferably in behavioral health).
  • Computer literacy and proficiency in Microsoft Excel and Word.
  • Understanding of state and regulatory grievance and confidentiality regulations.
  • Ability to handle confidential material with discretion and integrity.
  • Excellent verbal and written communication skills.
  • Ability to work independently and in a team environment.
What We Offer

As a Behavioral Health Claims Representative at Billing Solutions, you will have the opportunity to work with a talented team, develop your skills, and contribute to the success of our company. We offer a competitive salary, a fully remote work environment, and opportunities for growth and development.



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