Medical Claims Specialist

About this 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) plays a critical role in the revenue cycle by ensuring accurate claim submission, timely payment posting, denial resolution, and reimbursement optimization. This position works closely with payers, providers, and internal departments to identify reimbursement issues, resolve claim barriers, and improve overall revenue cycle performance. Key Responsibilities: Serve as a primary point of contact for phone calls and internal communications. Post and reconcile insurance and patient payments accurately and timely. Review claims for billing, coding, and documentation accuracy prior to submission and when researching payment issues. Investigate, analyze, and resolve denied, underpaid, or delayed claims by identifying root causes and implementing corrective actions. Prepare, submit, and track appeals to ensure timely resolution and maximum reimbursement. Monitor denial and reimbursement trends and proactively recommend process improvements to reduce future claim issues. Maintain accurate and thorough documentation of all account activity within the electronic health record and practice management systems. Collaborate with providers, clinical support staff, and other departments to resolve billing and reimbursement concerns. Stay current on payer policies, reimbursement guidelines, coding updates, and industry best practices. Participate in departmental projects and perform other duties as assigned. What We're Looking For: We are seeking a team member who demonstrates accountability, attention to detail, and persistence when solving complex reimbursement challenges. The ideal candidate is highly organized, analytical, and committed to delivering accurate results in a fast-paced healthcare environment. Required Qualifications: High school diploma or equivalent. Minimum of two (2) years recent experience in medical billing, claims management, accounts receivable, or revenue cycle. Working knowledge of medical billing, insurance claims processing, and denial management. Proficiency with electronic health records (EHRs), practice management systems, and Microsoft Office, and Google Workspace applications. Strong written and verbal communication skills. Exceptional attention to detail, accuracy, and organizational skills. Preferred Qualifications: Experience in behavioral health, psychiatry, or mental health billing. Direct, recent experience with insurance payment posting and reconciliation. Knowledge of CPT, ICD-10, and HCPCS coding. Experience preparing and managing insurance appeals. Familiarity with AdvancedMD or similar healthcare software. Success Factors: Takes ownership of work and follows issues through to resolution. Demonstrates strong critical thinking and problem-solving abilities. Maintains productivity while managing multiple priorities and deadlines. Communicates professionally and effectively with payers, providers, and team members. Identifies opportunities for process improvement and reimbursement optimization. Salary Range: $23.15-$28.29 (based on experience) Medical, Dental, & Vision Insurance (company covers a very generous portion) 401(k) with 5% employer match Paid Time Off Paid Holidays Continuing Education Fund Bonus Program #J-18808-Ljbffr