Job Description
Job Description
Claims Specialist
Location: Boca Raton, FL (on-site)
Pay range: $20 - 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