Claim Resubmission Specialist - #1406755

Job Details

Description

Banyan Treatment Centers is seeking a detail-oriented and proactive Claim Resubmission Specialist to support our revenue cycle operations. In this role, you will be responsible for analyzing and correcting denied insurance claims to ensure timely and accurate reimbursement in accordance with payer guidelines.

Position Details

• Location: Pompano Beach, FL (On-site)
• Reports to: Resubmission Process Lead & Director of RCM
• Schedule: Full-time
  
  

Key Responsibilities

• Ensure timely resubmission of claims in accordance with payer-specific guidelines and filing deadlines.
• Efficiently utilize Ebridge and CollaborateMD systems to track claim statuses, access EOBs, and verify corrections.
• Document resubmission activities clearly and consistently within practice management systems, maintaining audit-ready records.
• Work closely with the Resubmission Process Lead to prioritize claims based on urgency, payer deadlines, and financial impact.
• Communicate status updates, escalation needs, and trends in denials or system issues to the Process Lead.
• Collaborate with billing/coding team members to resolve billing discrepancies.
• Assist in contacting payers when necessary to clarify denial reasons or confirm receipt and status of resubmitted claims.
• Monitor and follow up on resubmitted claims to verify payment or next actions.
• Run, review, and interpret reports from billing software, Ebridge, and Excel to identify denial trends and prioritize high-impact issues.
• Maintain accurate documentation of all resubmission activities and communication with payers.
• Stay updated on payer policies, coding guidelines, and regulatory changes affecting reimbursement.
• Assist with other revenue cycle tasks as needed to support the overall efficiency of the billing team.
• Contribute to improving workflows, standard operating procedures, and resubmission documentation templates.
  
  

Qualifications

• High school diploma or equivalent, required; Associate's or higher, preferred.
• Minimum of 2 years of experience in medical billing or claims processing, with a focus on denial management and resubmissions.
• Proficiency in Kipu and CollaborateMD, preferred.
• Strong attention to detail and ability to analyze complex claims data.
• Knowledge of ICD-10, CPT, HCPCS codes.
• Database management skills include querying, reporting and document generation.
• Knowledge of the Principles and Practices of the discipline of account billing and collections.
• Familiarity with insurance carriers and their designated managed care, billing, and related agencies.
• Working knowledge of behavioral health billing practices, insurance reimbursement processes, and compliance standards.
• Ability to work as a team member and have communication, organizational and interpersonal skills.
  
  

Why Join Banyan Treatment Centers?

This Is An Opportunity To Make a Meaningful Impact Within a Leading National Provider Of Behavioral Health Services. As Our Claim Resubmission Specialist, You Will

• Join a Recognized and Mission-Driven Organization: Accredited by The Joint Commission, Banyan operates 18 locations and a growing Telehealth program, supported by 1,600+ employees delivering high-quality, compassionate care. Be Part of Strategic Growth: Backed by TPG’s Rise Fund, Banyan is expanding its reach in providing life-changing services across the nation.
• Drive Operational Excellence: Ensure timely, accurate claims resubmissions that support reimbursement integrity and sustainable operations.
• Enjoy Comprehensive Benefits: Medical, dental, and vision insurance; life and disability coverage; 401(k) with employer match; paid time off and holidays; wellness programs; and more.
  
  

Apply Now

Join Banyan Treatment Centers as a Claim Resubmission Specialist and help ensure accurate, timely reimbursement in support of quality behavioral healthcare. Apply today and grow your career with a leading, mission-driven organization.

EOE