Behavioral Health Claims Specialist

2 hours ago


Sandy, United States Threshold Billing Solutions Full time
Job Title: Behavioral Health Claims Specialist

Threshold Billing Solutions is seeking a skilled Claims Specialist to join our team. As a Claims Specialist, you will play a crucial role in analyzing and following up on behavioral health claims to ensure timely and appropriate reimbursement.

Key Responsibilities:
  • Claims Management: Handle the submission, status updates, and resolution of Commercial, Medicaid, and Government behavioral health claims.
  • Claim Status Tracking: Ensure timely follow-up on submitted claims, meeting established productivity goals.
  • Denial Resolution: Identify and resolve denied or rejected claims, providing feedback on recurring issues to improve processes.
  • Medical Records Submission: Collect and submit medical records to insurance companies as needed.
  • Patient Eligibility Verification: Confirm coverage for new patients and communicate eligibility statuses.
  • Collaboration: Work closely with behavioral health facilities, insurance companies, and credentialing departments to resolve billing inquiries.
Qualifications:
  • Experience with insurance claims for behavioral health, including Medicaid and Commercial payers.
  • Ability to maintain detailed notes and adhere to HIPAA regulations.
  • Strong communication and problem-solving skills.
  • Familiarity with online clearinghouses and claims software is a plus.

At Threshold Billing Solutions, we value teamwork, integrity, and professional growth. If you are a motivated and detail-oriented individual with a passion for behavioral health, we encourage you to apply for this exciting opportunity.



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