Insurance Billing & Claims Management
- Submit and manage insurance claims (primarily Aetna and BCBS) via our EHR system (SimplePractice)
- Follow up on claim denials and rejections, including calling insurance companies to resolve issues efficiently
- Maintain thorough records of communication with insurance carriers and escalate unresolved issues as needed
- Ensure compliance with payer requirements and timely submission of all claims
Client Billing & Benefits Coordination
- Verify insurance benefits for all incoming clients who plan to use insurance for therapy services
- Accurately calculate client responsibility (copay, coinsurance, deductible) and communicate with clients
- Follow up with clients regarding outstanding balances, initiate and manage payment plans, and address billing concerns in a timely, compassionate manner
- Manage all invoicing, billing, and payments from external partnerships and payors, ensuring timely and accurate processing in alignment with contractual agreements.
Payroll & Contractor Compensation
- Run biweekly payroll and issue payments for all clinicians based on completed sessions
- Track session counts and clinician earnings to ensure accuracy and transparency
- Resolve any payroll discrepancies in collaboration with clinicians and leadership
Financial Reporting & KPI Tracking
- Generate and analyze weekly, monthly, and quarterly financial reports to assess overall practice health
- Share weekly KPI summaries with the team and present key financial metrics during monthly staff meetings
- Work with the Clinical Lead to provide clinician-specific data (e.g., session count, revenue per client) that supports performance accountability and growth
Onboarding & Administrative Support
- Support onboarding of new clinicians with financial procedures and documentation, including collecting W-9, I-9, and direct deposit details
- Ensure clinicians understand how to document and track billable sessions, copays, and cancellations
- Assist with administrative hiring tasks as needed, including benefits documentation and credentialing coordination
Process Optimization & Compliance
- Identify inefficiencies or bottlenecks in billing and reporting workflows and recommend solutions
- Maintain compliance with HIPAA, insurance regulations, and IRS requirements
- Maintain an up-to-date Standard Operating Procedure (SOP) for all billing-related tasks and ensure that any changes to financial policies or procedures are reflected in the practice’s Operations Manual and Employee Manual.