Claims Specialist

Job Description

Job Description

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

● Submit clean claims daily and monitor payer responses

● Follow up consistently to ensure claims move through the system without delay

● Investigate denials and rejections, correct errors, and submit appeals when needed

● Communicate directly with payers to obtain claim status updates and reference numbers

● Maintain clear, audit-ready documentation in EMR and tracking tools

● Partner with billing leadership to reduce AR days and improve payment turnaround

● Identify denial trends and recommend workflow improvements

Requirements

Experience

● 1-3 years in behavioral health claims processing or revenue cycle operations

● Behavioral health experience preferred (SUD/MH a plus)

● Strong understanding of payer claim workflows and denial resolution

● Proven ability to manage multiple claims with urgency and accuracy

Education / Training

● Associate’s or Bachelor’s degree preferred (or equivalent experience)

● Comfort with EMR systems, clearinghouses, and structured trackers

● Experience with appeals and payer portals is a plus

Character Traits

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

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

● Detail-obsessed executor: Catches small errors before they become reimbursement delays

● Strong payer communicator: Confident, professional, and effective on insurance calls