What are the responsibilities and job description for the Claims Specialist position at Therapy and Beyond - ABA Therapy?
Company Description
Therapy & Beyond is one of the largest BCBA-owned ABA organizations, founded and led by Dr. Regina Crone, BCBA-D, since 2006. At Therapy & Beyond, we approach the needs of each patient both individually and as part of a dynamic interdisciplinary team working with experts in Applied Behavior Analysis (ABA) therapy, Speech-Language Pathology, and Occupational Therapy. We love helping individuals reach their full potential by supporting not only the patient but also their family. Above all, we grow potential by putting people first, doing our best together, and making therapy fun!
Job Description
As a Claims Specialist, you are the engine behind our financial health. You’ll be navigating the complexities of the healthcare reimbursement cycle to ensure accuracy, transparency, and efficiency. You will act as a vital bridge between our clinics and insurance payers, ensuring that the care our patients receive is reflected accurately in our billing. This role is based in Flower Mound, TX and will work very closely with multiple departments to ensure strong communication among the various stakeholders.
JOB SPECIFIC FUNCTIONS:
Starting Hourly Rate: $19 - $22 per hour
Status: Full time, non-exempt
Therapy & Beyond is one of the largest BCBA-owned ABA organizations, founded and led by Dr. Regina Crone, BCBA-D, since 2006. At Therapy & Beyond, we approach the needs of each patient both individually and as part of a dynamic interdisciplinary team working with experts in Applied Behavior Analysis (ABA) therapy, Speech-Language Pathology, and Occupational Therapy. We love helping individuals reach their full potential by supporting not only the patient but also their family. Above all, we grow potential by putting people first, doing our best together, and making therapy fun!
Job Description
As a Claims Specialist, you are the engine behind our financial health. You’ll be navigating the complexities of the healthcare reimbursement cycle to ensure accuracy, transparency, and efficiency. You will act as a vital bridge between our clinics and insurance payers, ensuring that the care our patients receive is reflected accurately in our billing. This role is based in Flower Mound, TX and will work very closely with multiple departments to ensure strong communication among the various stakeholders.
JOB SPECIFIC FUNCTIONS:
- Revenue Lifecycle Management: Own the end-to-end claims process, including collecting, posting, and managing patient payments with high precision.
- Claim Integrity: Meticulously verify visit details—including time, location, and insurance authorization—to minimize denials before they happen.
- Strategic Payer Follow-up: Proactively track remits and engage with insurance payers to resolve outstanding issues and ensure timely reimbursement.
- Cross-Functional Collaboration: Partner closely with clinic staff and internal departments to clarify billing entries and provide updates on ongoing claim developments.
- Compliance & Accuracy: Ensure all claims utilize correct billing information (providers, modifiers, and clinic locations) before final submission.
- Queue Management: Efficiently filter and manage daily patient billing lists by clinic and date.
- Authorization Oversight: Maintain a "Hold" protocol for temporary authorizations or insurance transitions to protect revenue integrity.
- Quality Control: Audit claims for appropriate modifiers and correct billing data points prior to transmission.
- Education: HS Diploma required; Degree in progress or completed preferred.
- Experience: 2 years of Medical Billing/RCM experience (preferred).
- Skills:
- Deep understanding of medical billing/coding and EPM systems.
- Proficiency in office technology and multi-line phone management.
- Exceptional organizational skills with high attention to detail.
- Strong interpersonal skills for effective team and patient communication.
Starting Hourly Rate: $19 - $22 per hour
Status: Full time, non-exempt
Salary : $19 - $22