Claims Technician

• Manage claims from initial insurance verification through submission, payment, and resolution.
• Submit and monitor insurance claims for accuracy and timely processing.
• Track outstanding, pending, denied, rejected, and unpaid claims.
• Investigate denials, correct claims, submit appeals, and follow up with insurance companies.
• Verify insurance benefits and assist with prior authorizations and reauthorizations.
• Assist with provider credentialing, recredentialing, and insurance enrollment.
• Track credentialing applications, effective dates, and outstanding requirements.
• Assist with client and staff scheduling and communicate schedule changes.
• Monitor schedules to ensure services align with insurance authorizations.
• Maintain accurate documentation of billing, credentialing, authorization, and insurance activity.
• Communicate with clinical and administrative team members to resolve billing and scheduling issues.
• Maintain confidentiality and follow HIPAA requirements.
• Complete additional administrative responsibilities as assigned.

• High school diploma or equivalent required; associate or bachelor’s degree preferred.
• Experience with medical billing, insurance claims, credentialing, scheduling, or healthcare administration preferred.
• Behavioral health or ABA billing experience is a plus.
• Understanding of insurance terminology, including authorizations, denials, appeals, EOBs, and claims.
• Strong attention to detail, organization, and time-management skills.
• Comfortable communicating with insurance companies and managing multiple priorities independently.
• Proficiency with computers, electronic records, insurance portals, and billing systems.