Position Summary
The Insurance/Billing Specialist is responsible for managing insurance billing, authorizations, claims submissions, client invoicing, and payment collection. This position plays a critical role in ensuring accurate billing practices and maintaining compliance with insurance and healthcare requirements.
The ideal candidate is highly organized, detail-oriented, and experienced in medical billing, insurance verification, claims processing, and healthcare administration.
Job Responsibilities
Insurance & Billing
- Verify insurance benefits and eligibility for new and existing clients.
- Submit insurance claims accurately and in a timely manner.
- Monitor claim status and follow up on unpaid or denied claims.
- Submit and track authorization requests and renewals.
- Review Explanation of Benefits (EOBs) and resolve billing discrepancies.
- Maintain accurate insurance and billing records.
- Process client invoices and collect payments.
- Work with families regarding billing questions and payment arrangements.
- Ensure compliance with payer requirements and company policies.
Provider Credentialing & Insurance Administration
- Complete provider credentialing and recredentialing applications.
- Maintain provider enrollments with insurance carriers.
- Update NPI information, provider directories, and online listings.
- Manage group and multi-discipline provider profiles.
- Assist with insurance contracting and networking efforts.
- Maintain accurate records of provider licenses, certifications, and insurance participation.
Administrative Support
- Answer incoming phone calls and assist clients with billing and insurance inquiries.
- Maintain organized electronic and physical records.
- Communicate with BCBAs and administrative staff regarding authorizations and insurance requirements.
- Assist with additional administrative duties as assigned.
Qualifications
Required Qualifications
- High School Diploma or GED.
- Minimum of one (1) year of experience in medical billing, insurance verification, claims processing, authorizations, or healthcare administration.
- Strong understanding of health insurance terminology and processes.
- Experience working with insurance portals and billing systems.
- Strong organizational and time-management skills.
- Excellent verbal and written communication skills.
- Ability to work independently and collaboratively within a team environment.
- Proficiency with Google Workspace, Microsoft Office and computer-based systems.
Preferred Qualifications
- Experience working in an ABA, behavioral health, therapy, or medical office setting.
- Experience with Office Ally, Availity, Waystar, and other insurance billing platforms.
- Associate's or Bachelor's degree in Healthcare Administration, Business, Accounting, or a related field. (preferred)
- Knowledge of provider credentialing and insurance enrollment processes.
- Experience with Medicaid and commercial insurance plans.
Benefits
- Competitive pay based on education, certifications, and experience.
- Opportunities for performance-based pay increases.
- Paid training.
- Professional development opportunities.
- Supportive and collaborative work environment.
- Health Insurance for eligible full-time employees.
- Dental Insurance for eligible full-time employees.
- Vision Insurance for eligible full-time employees.
- Paid holidays and additional benefits may be available based on employment status.
Pay: $20.00 - $27.00 per hour
Benefits:
- Dental insurance
- Employee discount
- Flexible schedule
- Health insurance
- Professional development assistance
- Tuition reimbursement
- Vision insurance
Work Location: In person
