The specialist will create and submit insurance claims from completed therapy sessions, verify client insurance benefits, post payments, and follow up on unpaid and denied claims. This role requires strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans.

Key Responsibilities

• Create and submit insurance claims in the practice management system from completed therapy sessions, reviewing each claim for accuracy before release
• Verify insurance eligibility and benefits for new and existing clients, including copays, deductibles, coinsurance, and behavioral health visit limits
• Check claim status and follow up on unpaid claims with BCBS PPO, Aetna, and UnitedHealthcare
• Review denials and rejections, submit corrected claims, and prepare appeals when needed
• Post insurance payments from ERAs and EOBs and reconcile client balances
• Track authorizations where a payer requires them
• Prepare superbills for out-of-network clients when requested by the practice
• Document all claim activity and payer communication clearly in the system
• Protect patient information and follow HIPAA requirements

Qualifications

• At least 1 year of experience with U.S. healthcare insurance
• Hands-on experience with claim submission, payment posting, and insurance follow-up
• Familiarity with commercial insurance and government health plans
• Experience using payer portals and insurance websites
• Strong written and spoken English
• Excellent attention to detail and follow-up skills
• Ability to work independently and manage multiple patient accounts
• Reliable internet connection and a suitable remote workspace

Preferred Qualifications

• Experience supporting mental health, behavioral health, or therapy practices
• Experience using PracticeQ (IntakeQ)
• Familiarity with Illinois insurance plans, including Blue Cross Blue Shield of Illinois
• Knowledge of psychotherapy CPT codes and behavioral health benefit rules

Schedule

• Part-time position, approximately 20 hours per week
• Must be available during Central Time business hours
• Final schedule will be determined based on practice needs

Work Arrangement

• Remote
• Philippines-based applicants preferred