Billing Operations Manager overseeing the Eligibility function within Billing Operations team at Caris Life Sciences. Responsible for insurance verification, leadership, and process improvements.
About the role
- Billing Specialist managing the full lifecycle of ABA claims billing and follow-up at Lumary. Collaborating with providers and internal teams to ensure accurate claim submissions and reconciliations.
Responsibilities
- The Billing Specialist is a vital member of the Lumary RCM Department, responsible for managing the full lifecycle of ABA claims billing and follow-up. This role ensures that claims are submitted accurately and timely, payments are properly posted and reconciled, and denials are addressed promptly. The Billing Specialist works collaboratively with providers and internal teams to maintain a clean accounts receivable and maximize revenue collection.
- Ensure accurate and timely submission of primary and secondary claims.
- Work on post insurance payments and reconcile payment data.
- Monitor and resolve claim rejections and escalate for assistance as needed.
- Work claim denials ensuring all denials are addressed within 3 days of remittance advice posting.
- Monitor and address assigned tasks in Lumary, including provider communications.
- Identify and report developing claim issues or patterns, escalating to leadership.
- Review and manage overpayments, initiate recoupment processes when necessary, and ensure payers post reconciliations appropriately.
- Audit each month in the quarter for missed billing and unacknowledged claims.
- Coordinate with providers to write off un collectable claims after thorough appeals process.
Requirements
- Experience in ABA or behavioral health billing preferred.
- Strong understanding of the medical claim lifecycle and payer reimbursement processes.
- Prior experience in Medicaid Billing.
- Experience in the ABA industry is preferred.
- Familiarity with ERA/EOB processing and electronic claim submissions.
- Detail-oriented with a high level of accountability and follow-through.
- Brings a solutions-first mindset, by asking the right questions and collaborating with senior team members to find resolutions.
Benefits
- Flexibility to work from home and the office - hybrid working environment if based at on office location in Denver, alternatively fully remote if not based near Denver
- Flexible start and finish times - have a routine but on the days you need to book an appointment or finish early, go for it
- Monthly town halls for connection and company alignment
- Monthly dedicated Social Connection days
- Quarterly employee engagement surveys (currently at 82% engagement and trending upwards)
- Internationally growing company working towards a purposeful vision: Empowering sustainable healthcare
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
No Education Requirement
Location requirements
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