Insurance and Coding Specialist

Responsibilities

• 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.
• Accurately post insurance and patient payments.
• Research payment variances, underpayments, and missing payments.
• Perform timely follow up on outstanding insurance claims.
• Work denied, rejected, and underpaid claims.
• Submit corrected claims, appeals, reconsiderations, and supporting documentation.
• 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

• 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.

About Brightline

Brightline is a therapy and psychiatry practice that delivers expert pediatric, teen, and parental mental health care to families and kids up to age 18. Brightline’s virtual and in-person outpatient services include diagnostic evaluation, therapy, psychiatry services (e.g. medication management), and psychological testing (to assess learning differences, school readiness, executive functioning difficulties [e.g. ADHD], and autism). In addition to Brightline’s generalized support, we offer focused programs including those that support anxiety, obsessive compulsive disorders, ADHD, and disruptive behaviors. Founded in 2019, Brightline has delivered care to tens of thousands of families with industry-leading results. We’ve been nationally recognized for clinical excellence and innovation for several years — recent awards include the Fast Company 50 Most Innovative Companies (2022) and Behavioral Health Business Companies to Watch Award (2024). Brightline is based in Palo Alto and is backed by investors including Boston Children’s Hospital, Northwell Health, Blue Cross Blue Shield of Massachusetts, Google Ventures, KKR, and Oak HC/FT.