Lead Accounts Receivable & Denial Specialist

At Affect Therapeutics, we are a mission-driven company where your work directly and immediately impacts the well-being of others. You will make a tangible difference in people's lives from day one. By providing medical and behavioral services through our digital recovery program, we unlock our members’ potential to not only rebuild their lives but also create a ripple effect of positive change in the lives of their families, friends, and society at large.

Join our incredible team at Affect as we expand our revenue and credentialing operations group. We are seeking an experienced Lead Accounts Receivable & Denial Specialist that is detail oriented and has bias for action to be responsible for managing the accounts receivable process, handling insurance claim denials, ensuring timely resolution, and maintaining accurate financial records. 

Key Responsibilities:

• Working with a sense of urgency, process and review incoming payments from members, insurance providers, and other sources.
• Post payments accurately to the appropriate accounts and resolve discrepancies.
• Actively monitor outstanding accounts and initiate follow-up to ensure timely collection.  Regularly report aged receivables; support resolution of outstanding balances.
• Build and maintain positive relationships with members and insurance companies to communicate payment issues and resolve billing inquiries.
• Work closely with internal teams (Billing, Finance, Clinical Services) to ensure accurate and efficient processing of claims and payments.
• Review denied insurance claims to identify reasons for denial.  Analyze EOBs (Explanation of Benefits), identify coding errors, and work with the billing team and external stakeholders to correct discrepancies.
• Appeal denied claims by preparing and submitting appropriate documentation, including medical records, statements, and additional information required by insurance providers.
• Track and monitor the status of appeals, ensuring timely follow-up and resolution.
• Ensure compliance with healthcare billing regulations, including HIPAA, and maintain confidentiality in all financial matters.
• Track and report on key performance indicators (KPIs) related to revenue cycle efficiency and claim resolution timelines.

Qualifications:

• High school diploma or equivalent required; Associate’s or Bachelor’s degree in Accounting, Finance, or related field preferred.
• Minimum of 2 years of experience in accounts receivable, denial management, or medical billing, particularly in a healthcare setting; preferably experience working in substance use disorder treatment or behavioral health
• In-depth knowledge of medical insurance policies and payor guidelines, claims processing, and treatment billing coding (CPT, ICD-10, HCPCS).
• Experience with insurance denial management and appeals processes.
• Proficiency in billing software and Microsoft Excel/Google Sheets; experience with Electronic Health Record (EHR) systems a plus.
• Demonstrated strong analytical skills with the ability to identify and resolve discrepancies.
• Excellent communication and customer service skills, with the ability to interact professionally with external stakeholders and internal teams to resolve issues.
• Ability to work independently and manage multiple time sensitive tasks.
• Have bias for action - Affect is a fast-paced work culture

We are unable to sponsor H1-B Visas at this time. Please do not apply if you are not within US time zones.

Join our team and contribute to our mission to transform the lives of individuals affected by substance use disorders through innovative treatment approaches, cutting-edge research, and compassionate care.

Additional Requirements & Working Conditions: 

The above job description is meant to describe the general nature and level of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required for the position.  

These physical demands are representative of the physical requirements necessary for an employee to successfully perform the essential functions of the job. Reasonable accommodation can be made to enable people with disabilities; these are made on a case-by-case basis. While performing the responsibilities of the role, the employee is required to talk and hear. The employee is often required to sit and use his or her hands and fingers. The employee is occasionally required to stand, walk, reach with arms and hands, climb or balance, and to stoop, kneel, crouch or crawl. Vision abilities required by this job include close vision.

This position is subject to a background check for any convictions directly related to its duties and responsibilities.  We will consider for employment all qualified applicants with arrest and conviction records, and will assess the details of any criminal conviction in a manner consistent with applicable law.  No background check will be conducted unless and until a conditional offer of employment has been made to an applicant.