Billing Specialist

The Hope Learning Center • Wexford, PA

3d

About The Position

The Hope Therapy Center is seeking an experienced, detail-oriented Medical Billing Specialist to work part-time. The role oversees key aspects of medical billing, including insurance authorizations, claims review, payment reconciliation, credentialing, and communication with insurance providers. The specialist works independently and collaborates with the clinical team and external billing partners to support smooth operations and accurate billing and reimbursement. Experience with Medicaid, commercial insurance, and pediatric or behavioral health services is especially valuable.

Employment is contingent upon completion of applicable Pennsylvania background clearances and onboarding documentation, including the Pennsylvania Child Abuse History Clearance (Act 33), Pennsylvania State Police Criminal History Clearance (Act 34), FBI Fingerprint Clearance (Act 114), as applicable, Act 168 Disclosure, when applicable, and Mandated Reporter Training.

Requirements

• At least 2 years of medical billing and coding experience.
• Experience working with multiple insurance payers, including Medicaid and commercial insurance.
• At least 1 year of experience with mental health, behavioral health, or pediatric therapy billing.
• Strong understanding of insurance authorizations, claims processing, payment reconciliation, and denials.
• Excellent written and verbal communication skills.
• Strong organizational skills and attention to detail.
• Ability to work independently, manage competing priorities, and meet deadlines.
• Proactive problem-solving skills and willingness to take ownership of responsibilities and improve processes.
• Completion of applicable Pennsylvania background clearances and required onboarding documentation, including Mandated Reporter Training.

Nice To Haves

• Experience with CentralReach.
• Familiarity with ABA, IBHS, or other pediatric therapy services.

Responsibilities

• Obtain, track, and maintain insurance authorizations to support uninterrupted client services.
• Maintain client and provider information in CentralReach, including staff accounts and reporting.
• Monitor billing activity and analyze reports to ensure claims are submitted accurately and on time.
• Review explanations of benefits, investigate payment discrepancies, and assist with claim denials and appeals.
• Identify outstanding claims, unpaid balances, and problem accounts, and work toward timely resolution.
• Coordinate provider credentialing and maintain enrollment with insurance companies.
• Serve as a point of contact between The Hope Therapy Center, insurance companies, clients, and third-party billing partners.
• Maintain familiarity with current billing codes, payer requirements, and insurance procedures.
• Collaborate with clinical and administrative staff to identify billing concerns and opportunities to improve workflows.
• Develop and maintain organized billing procedures, documentation, and best practices.
• Identify opportunities to maximize authorized services and support the delivery of care to clients.

Benefits

• Flexible part-time scheduling.
• Opportunity to support therapy services for children and families.
• Independent work with ownership of responsibilities.
• Collaborative work with a dedicated clinical and administrative team.
• Opportunity to help improve systems supporting a growing therapy program.

What This Job Offers

• Job Type: Part-time
• Education Level: No Education Listed