Claims Processing & Billing Specialist

Professional Physical TherapyMelville, NY

$24 - $26 / hour

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Overview

Schedule

Full-time

Career level

Senior-level

Remote

Hybrid remote

Compensation

$24-$26/hour

Benefits

Paid Holidays

Paid Vacation

Paid Sick Leave

Job Description

Claims Processing & Billing Specialist

Full-Time | Hybrid

Hourly Rate: $23.64 - $25.51 (commensurate with experience)

The Claims Processing & Billing Specialist is responsible for the accurate and timely submission of institutional and professional medical claims. Reporting to the Manager of Claims Processing & Credentialing, this role reviews claims in the Raintree EMR system, resolves billing edits and clearinghouse exceptions, and works closely with payers, patients, providers, and internal teams to support efficient reimbursement.

What You'll Do

Submit accurate institutional (UB-04) and professional (CMS-1500) claims to commercial and government payers.
Review and resolve claim edits, billing errors, clearinghouse exceptions, and rejections.
Submit corrected claims and ensure successful claim transmission to payers.
Verify patient eligibility and resolve coverage or demographic discrepancies prior to claim submission.
Communicate with insurance carriers, patients, providers, and internal teams to resolve billing issues.
Complete billing reviews, post splint charges, and enter charges into the DOL and Claim Connect portals.
Monitor claims processing inboxes and follow up on outstanding clearinghouse responses.
Navigate the Raintree EMR system to resolve claim issues and document account activity.
Meet departmental productivity and quality standards while maintaining compliance with HIPAA and other applicable regulations.
Stay current on payer policies and billing guidelines.
Perform other duties and special projects as assigned.

What You'll Bring

3+ years of Revenue Cycle or medical billing experience.
Strong knowledge of institutional (UB-04) and professional (CMS-1500) billing.
Experience with commercial and government insurance payers.
Proficiency with the Raintree EMR system.
Strong analytical, organizational, and problem-solving skills with exceptional attention to detail.
Proven ability to manage multiple priorities, work independently, and consistently meet productivity goals.
Cross-functional Revenue Cycle experience is a plus.
Bachelor's degree preferred.
Commitment to professionalism, teamwork, confidentiality, and excellent customer service.

Benefits

Rest, Reset & Recharge: 2 weeks PTO; Sick time in accordance with state and local requirements; plus 6 major holidays.

Plan Ahead: Company-matched 401(k) once eligibility requirements are met.

Commute Smart: Pre-tax transit and parking benefits through WageWorks (for eligible in-office employees).

Care for Your Crew: MetLife Pet Insurance with flexible plans, up to 90% reimbursement on eligible expenses, and 24/7 telehealth support.

Play More, Pay Less: Exclusive discounts through PlumBenefits and LifeMart on travel, entertainment, shopping, dining, and more.

Equal Opportunity Employer, including Disabled/Veterans.

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FAQs About Claims Processing & Billing Specialist Jobs at Professional Physical Therapy

What is the work location for this position at Professional Physical Therapy?

This job at Professional Physical Therapy is located in Melville, NY, according to the details provided by the employer. Some roles may also include multiple work locations depending on the requirement.

What pay range can candidates expect for this role at Professional Physical Therapy?

Candidates can expect a pay range of $23.64–$25.51 per hour for this role.

What employment applies to this position at Professional Physical Therapy?

Professional Physical Therapy lists this role as a Full-time position.

What experience level is required for this role at Professional Physical Therapy?

Professional Physical Therapy is looking for a candidate with "Senior-level" experience level.

What benefits are offered by Professional Physical Therapy for this role?

Professional Physical Therapy offers following benefits: Paid Holidays, Paid Vacation, Paid Sick Leave, and 401k Matching/Retirement Savings for this position. Actual benefits may vary depending on the employer's policies and employment terms.

What is the process to apply for this position at Professional Physical Therapy?

You can apply for this role at Professional Physical Therapy either through Sonara's automated application system, which helps you submit applications 10X faster with minimal effort, or by applying manually using the direct link on the job page.