Claim Specialist

About Purple Sky Counseling

Purple Sky Counseling is a growing multi-location mental health practice with 6 locations, focused on providing high-quality care while building strong, efficient systems that support both our clients and our team.

We are actively strengthening our billing and revenue cycle processes and are looking for a detail-oriented, accountable team member to support claims, denials, and account accuracy within our billing department.

Position Overview

The Claim Denial Specialist plays a key role in managing insurance claims, tracking and resolving denials, and ensuring the accuracy of client accounts within SimplePractice.

This role is responsible for identifying issues that impact reimbursement, maintaining clean and accurate account data, and supporting timely revenue collection.

This is an ideal role for someone with mental health billing experience, especially in insurance denials, claims follow-up, and account auditing. This role is primarily working denied claims.

This is a part-time position, with the opportunity to grow into full-time.

Primary Responsibilities

Claims & Denial Management

• Track, organize, and manage all insurance denials within SimplePractice
• Review denied and rejected claims to determine root cause
• Ensure denials are addressed, reassigned, or escalated in a timely manner
• Collaborate with billing team to support resolution of denied claims
• Monitor trends in denials and communicate patterns to leadership
• Direct phone contact with insurance companies (phone number provided though VOIP Phone system)
• Connecting with insurance representatives to identify denial causes quickly

Account Review & Aging

• Review aging reports to identify outstanding balances
• Audit client accounts for accuracy and resolve discrepancies
• Ensure accounts are accurate prior to client communication or escalation
• Support reduction of aging balances, especially accounts over 60–90 days

Autopay & Payment Oversight

• Maintain and monitor credit card and autopay systems within SimplePractice
• Identify and resolve failed or declined payments
• Ensure autopay enrollments are accurate and functioning properly

Billing Support

• Assist with backlog cleanup and account corrections
• Support Billing Operations and Revenue Cycle Manage with projects and workflow improvements
• Maintain clear and organized documentation of all work completed

Systems & Compliance

• Work within SimplePractice to update claims, accounts, and notes accurately
• Maintain HIPAA compliance at all times
• Follow internal billing workflows and SOPs

Key Performance Indicators (KPIs)

Denials

• 100% of new denials logged and categorized within 48 hours
• 90%+ of open denials actively worked each week
• Reduction in repeat denial types over time

Aging & Accounts

• 95%+ of assigned aging accounts reviewed weekly
• Measurable reduction in accounts over 90 days
• <2% error rate in audited account balances

Autopay

• 98%+ successful autopay rate
• 100% of failed payments addressed within 48 hours

Workflow & Productivity

• Tasks completed within assigned timelines
• Backlog maintained at or below defined thresholds
• Clear documentation of work completed in SimplePractice

Qualifications

• Experience in medical or mental health billing required
• Experience with insurance denials and claims follow-up strongly preferred
• Experience using SimplePractice (preferred) or similar EHR/billing systems
• Strong attention to detail and organizational skills
• Ability to work independently and manage multiple workflows
• Strong problem-solving and critical thinking skills

Preferred Experience

• Mental health/private practice billing
• Familiarity with insurance payors and claim lifecycle
• Experience working with aging reports and account audits

What We Offer

Part-Time Benefits:

• Supportive and structured team environment
• Clear roles and accountability
• Opportunity to grow within a developing billing department
• Flexible scheduling (if applicable)
• 401k + Matching

Full-Time Benefits:

• All part-time benefits listed above
• 40 hours PTO offered at 12 mos of full-time employment
• Holiday PTO offered after probationary period (90 days)
• Insurance (for FT employees)
• Costco Membership (for FT employees)

If you are detail-oriented, reliable, and experienced in claims and denial management, we’d love to hear from you.

To apply, please submit your resume and a brief summary of your billing experience.

Pay: $20.00 - $24.00 per hour

Benefits:

• 401(k) matching
• Flexible schedule
• Work from home

Application Question(s):

• In which state do you reside? (Must be in the US)
• Do you hold a credentials in Medical Billing? If so, which certificate do you hold?
• How many years of experience do you have working denied insurance claims?
• Do you have a remote, HIPAA Compliant location to work in?

Work Location: Remote