Boulder Care is looking for a Medical Claims & Billing Specialist for a 100% remote, full-time position. Candidates must reside and work in one of the following states to be considered for the role: AZ, CO, FL, GA, ID, IL, MA, NC, NJ, NY, OH, OR, PA, TX, UT, WA, and WV
About us
Founded in 2017, Boulder Care is a digital clinic offering long-term addiction treatment grounded in kindness, respect, and unconditional support. Our program is designed by addiction medicine specialists and people with lived experience of recovery. It is rooted in years of clinical expertise, proven research, and learnings from our participants.
Our mission is to improve the lives of people with substance use disorders. We provide the medication, resources, and support to help our participants succeed on their own terms, wherever they are in their journey.
Backed by world-class investors like Qiming Venture Partners (US), Goodwater Capital, Laerdal Million Lives Fund, First Round Capital, Greycroft, Tusk Venture Partners and Gaingels, with $50M in funding, Boulder is in an exciting stage of rapid growth.
About this role
Boulder Care is seeking a Medical Claims & Billing Specialist who will be responsible for all phases of the revenue cycle, from claims submission through payment posting and denied or outstanding claims resolution. This role will also work closely with the Enrollment Team to ensure quick resolution to eligibility issues and other patient billing inquiries. This position requires a details-driven, organized operator, with a knack for building and maintaining strong relationships with staff members and patients.
Success in this role
- Ensure accurate and timely billing of all claims to the appropriate third party payers
- Insurance payment posting and account reconciliation
- Identifying and correcting billing errors and resubmitting claims to insurance carriers
- Research/rectify third party denials/edits, requests for information and other related correspondence
- Follow up with patients for outstanding balances, work with them to set up payment plans, or other assistance.
- Act as key contributor to the Revenue Cycle by identifying and reporting inefficiencies and opportunities that enhance revenue flow, decrease denials, and minimize write-offs
- Other duties as assigned by the Billing Leadership
Requirements for the role
- 5+ years of experience in a healthcare setting specific to billing, and accounts receivable (i.e. claims, adjustments, payments)
- Ability to interpret and apply insurance payer billing guidelines, claim rules, and contract terms
- Proficiency in government, commercial and/or insurance payer claims follow-up, denial resolution, and appeals processes
- CPT and ICD coding knowledge
- Knowledge of ANSI 837 and 835 files, including how to read and interpret
- Exceptional written and verbal communication with an ability to effectively liaise with key stakeholders, including patients
- Demonstrates sensitivity and tact in interpersonal relations
- Team-focused; effective collaboration. Serves both the team and the customer at a consistently high level
- Demonstrates problem-solving and analytical skills appropriate for the position
- Demonstrates high ethical standards of behavior
- Maintains composure under pressure
- Regularly demonstrates Boulder’s core values
Nice to have but not required
- Prior experience with Kareo
- Knowledge of, and passion for healthcare/ SUD space
- Previous experience in a highly collaborative, team-based start-up environment
- Previous remote work experience
- Medicaid experience in either North Carolina and/or Ohio
Work environment
- This is a fully remote role but we are currently only hiring candidates located in the following states: AZ, CO, FL, GA, ID, IL, MA, NC, NJ, NY, OH, OR, PA, TX, UT, WA, and WV. Applicants must reside and work in one of those states to be considered.
Expected hours of work
This is a full-time remote position expected to work 40 hours during standard business hours.
Compensation
The starting pay range for this position is $26-$29 an hour commensurate with experience and is eligible for our comprehensive benefits package below
Hiring Timeline
- First Interview: 30-minute phone
- Panel Interview: 45 min video
- Final Interview: 30 min video
- Anticipated Start Date: Jan 27th, 2025
Some of Boulder’s amazing benefits for regular, full-time employees
- Contribution to meaningful, life-saving work!
- Health coverage through Cigna. Dental and vision coverage through MetLife
- Short-Term Disability
- Mental Health Services including MDLive, Talkspace, and EAP
- 4 weeks of PTO accrued per calendar year with a tenured increase to 5 weeks at 2 years of employment
- Sick leave accrued at 1 hr for every 30 hrs paid
- 9 Paid Holidays per year
- 12 weeks of 100% paid parental leave for the birth or adoption of a child (after 6 months of employment)
- 401(k) retirement savings
- Remote friendly with hardware provided to complete your work duties
Our values
- The people we care for always come first
- Our opportunity is also our duty, in service to others
- Share facts to change minds, instill empathy to change hearts
- Move the industry forward: follow the data
- Strong individuals, stronger together
Why work at Boulder?
- Make a difference. The devastating impact of the opioid crisis, “war on drugs,” and care gaps for the underserved are at the forefront now more than any time in US history. By bringing care to more people, we are changing and saving lives. Value-based partnerships help move the industry forward toward a more modern, compassionate, and equitable healthcare system.
- Build your career with talented peers. Boulder brings together a diverse team of expert clinicians, technologists, researchers, and business strategists aligned under a common mission. Boulder’s clinical teams are the leading voices in addiction medicine and industry transformation. Our technology leadership has built products and services that scaled to hundreds of employees and hundreds of millions of end-users. Our team is wholly driven by mission, recognizing that our immense opportunity is also our duty to serve others.
- Grow with us. Boulder is a Series-B-stage, venture-funded company supported by some of the best investors in the country. Together, we're building a massive business through social impact. According to White House estimates, the opioid crisis cost the US $500 billion in 2015. A member with untreated opioid use disorder (OUD) drives 550% greater healthcare costs to payers than the average member (UHC analysis, 2019). Boulder partners with leading commercial and Medicaid health plans to bring better experiences and effective services to their members, significantly reducing costs and sharing in the economic savings we create.
Boulder Care believes the people who manage our product and team should be representative of those who use the platform. This includes people from backgrounds that are historically underrepresented in the industry. We celebrate differences and are committed to equal employment opportunities regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, citizenship, marital status, disability, gender identity or veteran status. If you are a qualified person with a passion for what we do, please apply!
