Behavioral Health Claims Specialist

Threshold Billing Solutions is actively seeking a motivated and detail-oriented Claims Specialist to join our Claims and Verification of Benefits team.

This role is crucial in analyzing and following up on behavioral health claims to ensure timely and appropriate reimbursement.

As a Claims Specialist, you will serve as an advocate for behavioral health facilities, managing the full claims lifecycle, including submission, follow-up, denial resolution, and verification of patient eligibility.

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.

Join a company that values teamwork, integrity, and professional growth. Apply today to become part of a team that makes a difference in behavioral health care.

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