Claims Specialist

Therapy and Beyond • Flower Mound, TX

4d • Onsite

About The Position

Therapy & Beyond is one of the largest BCBA-owned ABA organizations, founded and led by Dr. Regina Crone, BCBA-D, since 2006. They 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. The company focuses on helping individuals reach their full potential by supporting not only the patient but also their family, emphasizing putting people first, doing their best together, and making therapy fun. As a Claims Specialist, you are crucial to the company's financial health, navigating the complexities of the healthcare reimbursement cycle to ensure accuracy, transparency, and efficiency. This role acts as a vital bridge between clinics and insurance payers, ensuring that patient care is accurately reflected in billing. The position is based in Flower Mound, TX, and requires close collaboration with multiple departments to ensure strong communication among various stakeholders.

Requirements

• HS Diploma required
• 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.

Nice To Haves

• Degree in progress or completed preferred.
• 2 years of Medical Billing/RCM experience (preferred).

Responsibilities

• Own the end-to-end claims process, including collecting, posting, and managing patient payments with high precision.
• Meticulously verify visit details—including time, location, and insurance authorization—to minimize denials before they happen.
• Proactively track remits and engage with insurance payers to resolve outstanding issues and ensure timely reimbursement.
• Partner closely with clinic staff and internal departments to clarify billing entries and provide updates on ongoing claim developments.
• Ensure all claims utilize correct billing information (providers, modifiers, and clinic locations) before final submission.
• Efficiently filter and manage daily patient billing lists by clinic and date.
• Maintain a "Hold" protocol for temporary authorizations or insurance transitions to protect revenue integrity.
• Audit claims for appropriate modifiers and correct billing data points prior to transmission.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees