Job Opportunities API

Insurance and Coding Specialist Remote · Reports to Manager, Revenue Cycle Brightline is a premier national youth mental health provider, delivering high quality virtual and in person care to families when and where they need it. Behind every claim, every code, and every dollar collected is a family who can keep getting care. You're the specialist who makes sure nothing falls through the cracks, from the moment eligibility is checked to the moment a claim is paid in full. Why This Role Brightline can only keep delivering care if the business behind it runs cleanly, and that starts with getting insurance and coding right the first time. This role sits at the center of that work, owning the accuracy and integrity of the revenue cycle from eligibility through final reimbursement. You'll work across the full revenue cycle, verifying eligibility, posting payments, following up on claims, and auditing coding and documentation for accuracy. Your attention to detail directly protects Brightline's financial health and keeps reimbursement moving so care never has to pause. Responsibilities Insurance Verification & Eligibility - Verify patient insurance eligibility and benefits prior to services. - Document eligibility findings accurately within the practice management system. - Identify and resolve eligibility discrepancies that could impact reimbursement. Payment Posting & Reconciliation - Accurately post insurance and patient payments. - Research payment variances, underpayments, and missing payments. Claims Follow Up & Denial Management - Perform timely follow up on outstanding insurance claims. - Work denied, rejected, and underpaid claims. - Submit corrected claims, appeals, reconsiderations, and supporting documentation. Coding & Documentation Audits - Perform routine provider documentation and coding audits to ensure coding accuracy and compliance. - Review CPT, ICD-10-CM, and modifier usage for appropriate code selection. - Identify documentation deficiencies and coding opportunities. REQUIREMENTS: - High school diploma or equivalent, required. Associate's or Bachelor's degree preferred. - AAPC Coding Certification (CPC or equivalent), required. - Experience with insurance eligibility verification, payment posting, claims follow up, and denial management. - Experience auditing provider documentation and coding for accuracy and compliance. - Working knowledge of CPT, ICD-10-CM, and modifier usage. - Strong analytical, organizational, and problem solving skills. - Excellent written and verbal communication skills. - Ability to work independently while managing multiple priorities in a fast paced environment. Benefits, Perks & Stipends We invest in our people with a comprehensive benefits package designed to support your health, your family, and your life outside of work: - Health coverage: Medical, Dental, and Vision insurance, plus Long-Term Disability, Life Insurance, a Flexible Spending Account, and a 401(k) - Time to recharge: 12 Company Holidays, Floating Holidays, and Paid Time Off — plus a company-wide Holiday Shutdown between Christmas and New Year's, so you can truly unplug knowing your teammates are offline too - Growing your family: Parental Leave to be present for what matters most - Perks & stipends: Health and Wellness Stipend, Home Office Reimbursement, License Maintenance Reimbursement, Commuter Benefits, and Professional Development Reimbursement to support how and where you do your best work At Brightline we have built a total rewards philosophy that includes fair, equitable, competitive, geo-based compensation that is performance and potential based. Our strategy is based on robust market research, including external advisory specializing in national compensation, and thoughtful input from every level of our organization. It is a combination of a cash salary, equity, benefits, wellbeing, and opportunity. In compliance with the Equal Pay f