This is a FULLY REMOTE position. Candidates residing within the Continental United States are welcome to apply.

Meliora Health is part of Healios, the UK's largest digital behavioral healthcare provider. Since 2013, we've provided digitally-led, comprehensive outpatient developmental and behavioral healthcare, focused exclusively on children and young people.

We innovate both clinically and technologically to deliver "better" care: we developed our own digital care platform; we created an in-house training academy to help our clinicians grow; and we are creating new clinical models to really improve outcomes.

We exist to empower every young person to build the capabilities for long-term mental health to successfully navigate life's challenges and experience a better quality of life. If this mission statement resonates with you, please do consider applying. We are making a difference in the lives of thousands of children and their families in the UK and the US.

THE OPPORTUNITY

As our Medical Billing Specialist, you will help our patients maximize their experience with Meliora Health. Successful candidates will be eager to join a growing, fast paced team, where you can have a key role in our success. You will have an opportunity to learn about our clinical service, our systems and how we support our members.

Under the direction of the Operations Manager, the Medical Claims Specialist will be responsible for complete, accurate and timely processing of all preauthorizations and claims, reviewing and responding to daily correspondence from physician practices in a timely manner, and providing information as requested. The Medical Claims Specialist will take steps necessary to resolve all claim issues or questions that escalate to the management team. We are scaling our clinical networks in markets across the US to help us achieve our mission: to empower every young person to build the capabilities for long-term mental health to successfully navigate life's challenges and experience a better quality of life.

Responsibilities:

• Process pre authorizations and claims in a timely manner
• Investigating denial sources, resolving and appealing denials which may include contacting payer representatives
• Process claim adjustments, resubmission, appeals, and other claim resolutions
• Collaborate with internal teams to ensure reimbursement is in line with payer contract agreements.
• Assist Client Success team with client support as needed
• Assists with projects as assigned.

What you need:

• Experience in a telehealth environment required.
• Experience in a startup, building billing practices a plus
• At least three years of medical claims experience (including Medicaid)
• Must understand Explanation of Benefit (EOB) statements
• Must provide accessibility to private, quiet work space with high-speed internet to effectively work remotely for days not in the office
• High School diploma

What we will provide for you:

• Opportunities for growth/development.
• Paid sick leave
• One time home office setup stipend
• A truly unique culture that challenges the status quo

Meliora Health participates in E-Verify

MELIORA HEALTH'S COMMITMENT TO EQUAL EMPLOYMENT OPPORTUNITY
At Meliora Health, we believe that changing the lives of children and their families requires every single person, no matter the race, color, religion, sex, sexual orientation, gender identity, age, national origin, veteran status, or disability. We are committed to equal opportunity in all parts of our business and are dedicated to creating a diverse team. That being said, we encourage all applicants from every background and life experience to apply.

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