Claims Specialist

Claims Specialist

Location: Boca Raton, FL (on-site)

Pay range: $22 - 24 (Based on Experience)

We deliver hands-on, process-driven operational support to behavioral health

programs. We’re hiring a Claims Specialist to drive accurate claim submission, denial

resolution, and consistent payer follow-through across our facilities.

This role is for someone who can manage claims with precision: clean submission, fast

follow-up, strong payer communication, and zero dropped tasks. You will be responsible

for ensuring claims move efficiently from billing to payment with clear documentation

and consistent resolution.

What You’ll Do

%CF; Submit clean claims daily and monitor payer responses

%CF; Follow up consistently to ensure claims move through the system without delay

%CF; Investigate denials and rejections, correct errors, and submit appeals when needed

%CF; Communicate directly with payers to obtain claim status updates and reference numbers

%CF; Maintain clear, audit-ready documentation in EMR and tracking tools

%CF; Partner with billing leadership to reduce AR days and improve payment turnaround

%CF; Identify denial trends and recommend workflow improvements

Requirements

Experience

%CF; 1-3 years in behavioral health claims processing or revenue cycle operations

%CF; Behavioral health experience preferred (SUD/MH a plus)

%CF; Strong understanding of payer claim workflows and denial resolution

%CF; Proven ability to manage multiple claims with urgency and accuracy

Education / Training

%CF; Associate’s or Bachelor’s degree preferred (or equivalent experience)

%CF; Comfort with EMR systems, clearinghouses, and structured trackers

%CF; Experience with appeals and payer portals is a plus

Character Traits

%CF; Denial-driven problem solver: Enjoys investigating into payer issues and resolving claim obstacles quickly

%CF; Persistent follow-through operator: Stays on claims until final payment is secured, no loose ends

%CF; Detail-obsessed executor: Catches small errors before they become reimbursement delays

%CF; Strong payer communicator: Confident, professional, and effective on insurance calls