Billing Specialist, Headspace Health

• 5+ years of Revenue Cycle Management experience with strong knowledge of medical claims and health plan/EAP rules
• Strong claims follow-up skills across denials, rejections, and underpayments; ability to independently drive resolution to closure
• Strong root-cause problem solving and attention to detail; high bar for accuracy and documentation
• Ability to prioritize effectively across competing work and communicate assumptions/needs early to reduce rework and unblock progress
• Proficiency in Excel and comfort using data to support reporting, reconciliation, and operational decision-making
• Strong communication and interpersonal skills; ability to collaborate cross-functionally in a fast-paced environment

Desirable

• The Billing Specialist (Insurance A/R) is responsible for ensuring timely and accurate insurance A/R resolution across a complex claims portfolio
• This role sits at the center of execution and problem-solving—driving follow-up, denials and underpayment resolution, cash acceleration, and process improvements that improve collections outcomes and reduce operational friction
• You will be expected to effectively and independently drive project execution, recommend solutions to enhance existing processes, prioritize between competing deliverables with sound judgment, and communicate assumptions up front to minimize rework
• Work assigned worklists of complex and high-risk accounts, meeting productivity and quality targets while driving timely A/R resolution
• Own key insurance collections workflows (e.g., recoupments) and billing / coding accuracy processes (e.g. coding and billing quality audits) end-to-end, driving complete, accurate, and SLA-compliant execution
• Resolve claim issues across rejections, denials, and underpayments through payer portal review, payer outreach, documentation review, and escalation pathways
• Research, review, and resolve exceptions and escalations surfaced by teammates and cross-functional partners, bringing issues to closure with strong documentation
• Maintain high-quality claim notes and documentation standards to ensure auditability, continuity, and efficient handoffs
• Conduct special projects (e.g. targeted payer issue review, A/R clean-up, etc.) and provide “SWAT” support for high-risk billing areas when needed to reduce write-offs and address aging risk
• Support weekly / monthly reporting and reconciliation activities and ensure accurate tracking of collections progress and payer behavior
• Assist with monitoring workload and KPIs, and contribute to the design and implementation of system / process changes and improvement initiatives
• Contribute to productivity and quality reporting processes, flagging gaps, trends, and opportunities to improve operational performance
• Partner in delivering team training and strengthening SOP documentation to drive standardized, high-quality execution
• Actively identify and advance AI and automation opportunities within collections workflows, partnering on pilots and driving adoption to improve efficiency and accuracy
• Conduct ongoing coding and billing accuracy reviews, implement corrective actions as needed, and partner with Clinical and QA teams to identify retraining and performance improvement opportunities
• Identify trending claim issues and root causes (rejections, denials, underpayments) and recommend practical remediation strategies to improve collections performance
• Recommend solutions to enhance existing workflows and leverage available resources to overcome unforeseen issues (e.g., payer constraints, system limitations, unclear routing)
• Prioritize between competing work and project deliverables with sound judgment, communicating assumptions and clarifying requirements up front to minimize rework
• Identify opportunities to standardize, automate, and reduce manual processes across collections workflows; support testing and adoption of improvements
• Partner with Product and Engineering on testing and validation of RCM workflow enhancements (e.g., UAT support, requirements feedback) when needed
• Work cross-functionally with internal teams (e.g., Clinical, Provider Ops, Client/Account partners, Member Support, etc.) to implement and optimize workflows for new and existing health plans, clients, and members
• What success looks like:
• Insurance A/R worklists are executed with speed, accuracy, and strong documentation, resulting in improved aging and collections outcomes
• Trends and root causes are surfaced early, with clear recommendations that reduce repeat issues and prevent avoidable denials or write-offs
• Competing priorities are handled with good judgment and proactive communication, minimizing rework and protecting team throughput
• Workflows become more standardized and efficient through practical improvements and automation support