Exact Billing Solutions
Claims Resolution Specialist – Behavioral Health
Location:
Lauderdale Lakes, FL
Pay Range:
$58,240.00/yr - $64,480.00/yr
Seniority level:
Associate
Employment type:
Full-time
Job function:
Other
Industries:
IT Services and IT Consulting
About the Company Exact Billing Solutions (EBS) is a unique team of revenue cycle management professionals specializing in substance use disorder, mental health, and autism care fields of healthcare services. With a proprietary billing process, EBS brings efficiency and innovation to partner healthcare companies, supporting global operations and exponential growth.
Role Overview As a Claims Resolution Specialist—Behavioral Health, you will coordinate with insurance companies and clients to secure maximum benefits, manage accounts receivable, and drive timely collections across expanding clinic locations.
Responsibilities
Review and manage assigned AR inventory to ensure timely follow‑up on outstanding claims.
Investigate and resolve denials, rejections, and underpayments by working directly with payors and internal teams.
Submit corrected claims, appeals, and additional documentation to secure reimbursement.
Document all collection activities clearly and accurately within our systems.
Monitor payor trends and escalate recurring issues to leadership.
Meet or exceed daily, weekly, and monthly productivity and quality standards.
Support special projects and process improvement initiatives as assigned.
Maintain effective communication with third‑party insurance carriers to resolve issues that impede cash flow and affect patient/member satisfaction.
Monitor and create reports on key metrics such as cash collections, days outstanding, unbilled claims, denials, daily census, etc.
Manage claim status and notes in the patient accounting system (CollaborateMD).
Escalate payor or client claim issues to department leadership.
Establish and maintain communication with leadership to ensure third‑party guidelines are satisfied.
Update patient demographics and insurance information as needed.
Achieve KPI metrics for productivity.
Qualifications
Associate’s degree (preferred).
Minimum 3 years of behavioral health out‑of‑network billing experience.
Knowledge of CollaborateMD EMR and billing software.
Experience with ABA therapy (preferred).
Familiarity with CPT and ICD‑10 codes (preferred).
Claims denial experience with follow‑up from payers, including appeals.
Benefits
21 paid days off (15 days of PTO, increasing with tenure, plus 6 holidays).
Flexible Spending Account (FSA) and Health Savings Account (HSA) options.
Medical, dental, vision, long‑term disability, and life insurance.
Generous 401(k) with up to 6% employer match.
Culture & Values Integrity, dependability, and attention to detail define our team. We are a fast‑paced, growing company that empowers clients to focus on patient care rather than administrative tasks.
Exact Billing Solutions participates in the U.S. Department of Homeland Security E‑Verify program.
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Location:
Lauderdale Lakes, FL
Pay Range:
$58,240.00/yr - $64,480.00/yr
Seniority level:
Associate
Employment type:
Full-time
Job function:
Other
Industries:
IT Services and IT Consulting
About the Company Exact Billing Solutions (EBS) is a unique team of revenue cycle management professionals specializing in substance use disorder, mental health, and autism care fields of healthcare services. With a proprietary billing process, EBS brings efficiency and innovation to partner healthcare companies, supporting global operations and exponential growth.
Role Overview As a Claims Resolution Specialist—Behavioral Health, you will coordinate with insurance companies and clients to secure maximum benefits, manage accounts receivable, and drive timely collections across expanding clinic locations.
Responsibilities
Review and manage assigned AR inventory to ensure timely follow‑up on outstanding claims.
Investigate and resolve denials, rejections, and underpayments by working directly with payors and internal teams.
Submit corrected claims, appeals, and additional documentation to secure reimbursement.
Document all collection activities clearly and accurately within our systems.
Monitor payor trends and escalate recurring issues to leadership.
Meet or exceed daily, weekly, and monthly productivity and quality standards.
Support special projects and process improvement initiatives as assigned.
Maintain effective communication with third‑party insurance carriers to resolve issues that impede cash flow and affect patient/member satisfaction.
Monitor and create reports on key metrics such as cash collections, days outstanding, unbilled claims, denials, daily census, etc.
Manage claim status and notes in the patient accounting system (CollaborateMD).
Escalate payor or client claim issues to department leadership.
Establish and maintain communication with leadership to ensure third‑party guidelines are satisfied.
Update patient demographics and insurance information as needed.
Achieve KPI metrics for productivity.
Qualifications
Associate’s degree (preferred).
Minimum 3 years of behavioral health out‑of‑network billing experience.
Knowledge of CollaborateMD EMR and billing software.
Experience with ABA therapy (preferred).
Familiarity with CPT and ICD‑10 codes (preferred).
Claims denial experience with follow‑up from payers, including appeals.
Benefits
21 paid days off (15 days of PTO, increasing with tenure, plus 6 holidays).
Flexible Spending Account (FSA) and Health Savings Account (HSA) options.
Medical, dental, vision, long‑term disability, and life insurance.
Generous 401(k) with up to 6% employer match.
Culture & Values Integrity, dependability, and attention to detail define our team. We are a fast‑paced, growing company that empowers clients to focus on patient care rather than administrative tasks.
Exact Billing Solutions participates in the U.S. Department of Homeland Security E‑Verify program.
#J-18808-Ljbffr