Medical Claims Specialist
About The Position
Bright Futures Psychiatry is expanding again and looking for passionate Medical Claims Specialists to join our team. We are a 100% PMHNP female owned practice, founded by an Air Force Veteran , and located in the beautiful Broadmoor area of Colorado Springs . Our mission is simple: remove barriers for providers so they can focus on delivering high-quality mental healthcare . Why Bright Futures Psychiatry? Collaborative & Supportive Culture – Work closely with PMHNPs and therapists in a team-driven environment. Client-Centered Approach – We empower you to practice at the top of your licensure and prioritize excellent client care. Work-Life Balance – Flexible scheduling with in-office, remote, or hybrid options, depending on the role. Strong Leadership & Growth – Be part of a team shaping the future of psychiatric care in Colorado. What You’ll Do: The Medical Claims Specialist (MCS) will be responsible for posting payments to client accounts, reviewing claims for coding accuracy, reviewing and analyzing denied claims from insurance companies and taking the necessary actions to appeal or resolve the denial. Review and analyze claims for coding accuracy Review and analyze denied medical claims to determine the reason for the denial Collaborate with healthcare providers, insurance companies, and other stakeholders to gather necessary information for appeal or resolution of the denial Develop and submit appeals for denied claims within the specified time frame Follow up on appeals and ensure that they are resolved in a timely manner Identify trends in denials and works to implement process improvements Provide guidance and support to healthcare providers and staff on the appeals process Ensure that all appeals are properly documented in the electronic medical records system Post payments to client accounts Stay up-to-date on changes to medical coding, billing, and insurance polices Other duties as assigned Join a team that values excellence, collaboration, and client care. If you're looking for a fulfilling career in a supportive environment, apply today! To apply, please submit your application through the job posting where you found this role or visit: https://www.brightfuturespsychiatry.com/careers
Requirements
- High school diploma or equivalent required, college degree preferred
- At least 2 years of experience in medical claims management (psychiatric preferred)
- Strong understanding of medical coding and billing practices
- Detail-oriented with strong analytical and problem-solving skills
- Familiarity with electronic medical records systems and other healthcare software
- Knowledge of insurance policies and regulations
Responsibilities
- Review and analyze claims for coding accuracy
- Review and analyze denied medical claims to determine the reason for the denial
- Collaborate with healthcare providers, insurance companies, and other stakeholders to gather necessary information for appeal or resolution of the denial
- Develop and submit appeals for denied claims within the specified time frame
- Follow up on appeals and ensure that they are resolved in a timely manner
- Identify trends in denials and works to implement process improvements
- Provide guidance and support to healthcare providers and staff on the appeals process
- Ensure that all appeals are properly documented in the electronic medical records system
- Post payments to client accounts
- Stay up-to-date on changes to medical coding, billing, and insurance polices
- Other duties as assigned
Benefits
- Medical, Dental, & Vision Insurance (company covers a very generous portion)
- 401(k) with 5% employer match
- Paid Time Off
- Paid Holidays
- Paid Sick Leave
- Student Loan Reimbursement Program
- Continuing Education Fund
- Bonus Program
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
