Medical Claims Specialist ($2,500 Sign-On Bonus)
Positions Available: 1
Job Classification: Full-Time (Hourly)
Pay Scale: $21.55-$25.17/hr
We are seeking self-motived high achievers to join our team. Bright Futures Psychiatry is 100% PMHNP owned (Female, Air Force Veteran). We know our work is vital to the success of our community, hence we take our work very seriously. We celebrate our victories and learn as much as possible from any failures.
Our goal is to remove all barriers to care and deliver high-quality mental healthcare in a timely fashion. At Bright Futures Psychiatry you will find a sense of belonging that promotes collaboration between our providers and our various support teams. Our company culture is one of warmth and inclusivity to both staff and clients.
The Medical Claims Specialist (MCS) plays a vital role in the day-to-day operations of Bright Futures Psychiatry. The MCS is responsible for reviewing and analyzing denied claims from insurance companies and taking the necessary actions to appeal or resolve the denial. This role requires a strong understanding of medical coding, billing, and insurance policies.
The MCS will be responsible for reviewing and analyzing denied claims from insurance companies and taking the necessary actions to appeal or resolve the denial. This role will require a strong understanding of medical coding, billing, and insurance policies.
- $2,500 Sign-On Bonus (qualification based on merit and conditions)
- Productivity Bonuses (paid quarterly)
- Bright Futures Psychiatry pays 100% of your Medical, Dental, and Vision monthly premiums
- 401k + 5% Match
- Paid Holidays + Birthday Holiday
- Opportunity to get Quarterly Goals Bonuses
Reasons You Should Want to Work With Us
We treat every member of our organization with respect and support one another as valuable teammates. We continue to grow because the need for mental health services has not been met yet in Colorado… we aim to meet this need. If you are interested in being part of a team that is actually making a difference in Colorado, you should apply, now.
Essential Duties & Responsibilities
- Review and analyze denied medical claims to determine the reason for the denial.
- Collaborate with healthcare providers, insurance companies, and other stakeholders to gather necessary information for appeal or resolution of the denial.
- Develop and submit appeals for denied claims within the specified time frame.
- Follow up on appeals and ensure that they are resolved in a timely manner.
- Identify trends in denials and works to implement process improvements.
- Provide guidance and support to healthcare providers and staff on the appeals process.
- Ensure that all appeals are properly documented in the electronic medical records system.
- Stay up-to-date on changes to medical coding, billing, and insurance policies.
- Other duties as assigned.
Requirements & Conditions
- High school diploma or equivalent required, college degree preferred.
- At least 2 years of experience in medical claims denial management.
- Strong understanding of medical coding and billing practices.
- Detail-oriented with strong analytical and problem-solving skills.
- Familiarity with electronic medical records systems and other healthcare software.
- Knowledge of insurance policies and regulations.
- The MCS may need to spend extended periods of time sitting at a desk and using a computer.
- Some travel may be required for meetings in office if working in a hybrid position.
- The employee must occasionally lift and/or move 20 pounds.
- Specialized equipment, machines, or vehicles used: Computers, copiers, and other standard office equipment.
Exhibits Our Core Values At All Times
- The power of collaboration: Collaboration and teamwork can bring about greater creativity, innovation, and productivity than individual work.
- Effective communication: Good communication is essential for successful teamwork. All team members should be able to express themselves clearly and listen actively.
- Respect and trust: Trust and respect among team members is crucial for effective teamwork. Team members should acknowledge and appreciate each other’s strengths and weaknesses.
- Roles and responsibilities: Each team member should have clearly defined roles and responsibilities. This helps to avoid confusion and promotes accountability.
- Conflict resolution: Conflict is inevitable in teamwork, but it can be managed effectively through open communication, active listening, and compromise.
- Celebrate successes: Celebrating successes as a team builds morale and motivation. This also helps to foster a positive team culture.
- Continuous improvement: Teams should always strive to improve their processes and outcomes. Regular feedback and evaluation can help identify areas for improvement.
- Leadership: Effective leadership is essential for successful teamwork. Leaders should set clear goals, delegate tasks effectively, and motivate team members towards achieving the team’s objectives.
- Diversity and inclusion: Teams should embrace diversity and promote inclusion. This creates a welcoming environment that values all team members and promotes creativity and innovation.
Bright Futures Psychiatry is an Equal Opportunity Employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.