Homeoffice Reimbursement Specialist at CLEANSLATE CENTERS INC

Description

We’re seeking an experienced and detail-oriented Reimbursement Specialist to join our billing team. In this role, you’ll manage the full revenue cycle process, with a focus on resolving claim rejections, denials, and patient billing inquiries. You’ll play a key role in ensuring accurate, timely reimbursement for medical and behavioral health services while helping maintain the financial integrity of the organization.

What You’ll Do:

• Review and resolve claim denials and rejections according to payer-specific guidelines

• Correct and reprocess denied claims and file appeals as necessary

• Respond to billing questions via email, phone, and mailed correspondence

• Review zero-pay Explanation of Benefits (EOBs) and take appropriate action

• Manage patient billing, including payment plans, statement generation, and follow-up calls

• Identify and communicate payer trends and recommend process improvements

• Collaborate with the billing team to ensure clean claims and accurate submissions

• Monitor Accounts Receivable (A/R), denial trends, eligibility, and refund processes

• Ensure compliance with payer contracts, privacy laws, and internal policies

• Maintain accurate documentation of claim activity and resolution

• Contribute to special projects and team initiatives as assigned

What We’re Looking For:

• High School Diploma or equivalent required; additional education in healthcare or business preferred

• 3–5 years of experience in healthcare revenue cycle management or reimbursement

• Strong understanding of insurance billing, payer policies, and denial management

• Knowledge of behavioral health billing and carve-out plans preferred

• Proficiency with Microsoft Office and electronic claim submission systems

• Excellent problem-solving, communication, and documentation skills

• Ability to work independently and collaboratively in a remote environment

• High attention to detail and ability to manage multiple priorities

Why Join Us?

• Monday–Friday schedule – no nights or weekends

• Remote-friendly work environment with minimal travel

• Competitive pay and comprehensive benefits package

• Generous PTO, floating holiday, and paid company holidays

• Medical, dental, and vision insurance + 401(k) with company match

• Company-paid life and disability insurance

Qualifications

• High-quality medication-assisted treatment (MAT) led by physicians and licensed medical providers in a convenient outpatient environment.
• Hand-on care, providing our patients with psychosocial support and intensive care coordination with a wide network of partners in every community. 
• Individualized mental health support, through one-on-one counseling, peer support or group sessions.

• Review submitted claim denials/rejections for accuracy and payer specific guidelines.
• Correct claim rejections, denials and file appeals based on internal and external guidelines
• Correctly respond to billing questions received via email, phone or mailed correspondence
• Utilize existing resources within the organization to properly resolve claims issues
• Review and address zero pay EOBs
• Patient billing including payment plans, printing/mailing bills, phone calls, etc.
• Identify and provide solutions for payer trends
• Billing Process Oversight: Billing Accounts Receivables, Denial Trends, Payment Posting, Eligibility, Refund Process
• Acceptable and reliable attendance and punctuality
• All other tasks or projects, as assigned.

• High School Diploma or Equivalent
• Three to Five years experience in Healthcare Revenue Cycle
• Intermediate knowledge of medical billing processes for medical and behavioral health services
• Intermediate knowledge of health insurance processes
• Intermediate knowledge of Microsoft Office products
• Intermediate knowledge of electronic claim submission processes
• Understanding of Behavioral Health carve out plans
• Understanding of Federal and State privacy laws understanding as they relate to healthcare revenue cycle
• Understanding of Payer Contracting and Enrollment
• Basic math skills and basic typing skills.
• This position is subject to a background check for any convictions directly related to its duties and responsibilities. We will consider for employment all qualified applicants with arrest and conviction records and will assess the details of any criminal conviction in a manner consistent with applicable law. No background check will be conducted unless and until a conditional offer of employment has been made to an applicant. This position must also successfully pass a pre-employment drug screening.

• Generous PTO package plus Holidays for full and part time positions
• 401K and Roth with Company match
• Affordable Medical plans for employees working a minimum of 30 hours per week
• Dental and Vision plans for employees working a minimum of 20 hours per week
• Flexible Spending Accounts for Healthcare and Dependent Care expenses
• Employer contribution to the HSA
• Employer Assistance Program with company paid visit allotment
• Company paid Life, AD&D, Short and Long Term Disability including part time employees