What are the responsibilities and job description for the Billing Operations Specialist position at Frontera Health?
Frontera Health is revolutionizing pediatric healthcare by developing a cutting-edge, tech-enabled platform that delivers essential therapies to rural families. Our platform leverages AI/ML to create a robust video-based data model for early intervention and developmental disorders. By collaborating closely with parents, caregivers, and clinical partners, we're bridging the gap in access to care, improving health equity, and providing personalized treatment plans. Backed by leading investors like Lightspeed and Lux, Frontera Health is poised for rapid growth.
Our ABA direct services are designed to meet the unique needs of children in underserved communities, providing them with the support and resources they require to reach their full potential. We are passionate about ensuring that every child, regardless of their location or socioeconomic status, has access to high-quality healthcare. By leveraging our technology platform and partnering with local providers, we are able to deliver effective ABA therapy to families who may otherwise have limited access to these essential services.
About the Role
Frontera Health is seeking a proactive and detail-oriented Billing Operations Specialist to join our growing Payer Operations team. In this role, you'll ensure the accuracy and efficiency of our end-to-end billing processes across all product lines, helping to maximize collections and minimize claim errors. You will serve as a key bridge between internal clinical and operational teams, external vendors, and payer partners (both Medicaid and commercial).
This is a hands-on role ideal for someone who enjoys problem-solving, thrives on process improvement, and is committed to getting the details right in a fast-moving healthcare environment.
What you'll do
- Claims Processing & Quality Assurance
- Ensure timely and accurate submission of all claims
- Monitor claims processing accuracy daily, weekly, and monthly
- Audit patient eligibility and insurance information to reduce downstream billing issues
- Denial Management & Resolution
- Partner with the Manager of Payer Operations and internal teams to resolve claim discrepancies and denials
- Identify trends in claim errors and rejections to drive process improvements
- Communication & Education
- Serve as a billing subject matter expert for internal teams
- Educate employees on billing policies, payer requirements, and documentation best practices
- Maintain clear and professional communication across stakeholders
- Process & Vendor Management
- Develop and maintain the Billing Operations Playbook
- Collaborate with vendors and external partners to streamline billing workflows
- Establish and manage invoicing and collections processes for all product lines
Qualifications
- 3 years of experience in healthcare billing operations or revenue cycle management
- Strong understanding of Medicaid and commercial payer policies and billing requirements
- Familiarity with billing systems and eligibility verification platforms
- Detail-oriented with excellent analytical and organizational skills
- Proven ability to collaborate cross-functionally and manage multiple priorities
- Excellent written and verbal communication skills
- Experience with ABA services or pediatric healthcare a plus
Why Join Frontera Health?
- Make a Difference: Impact the lives of children and families navigating Autism Spectrum Disorder (ASD) and support them in reaching their goals.
- Collaborative & Mission-Driven Environment: Join a team that values support, collaboration, and ongoing growth within a fast-growing organization.
- Professional Development: We invest in your career advancement through ongoing training and mentorship.
- Comprehensive Benefits: Enjoy competitive compensation and benefits as part of a mission-driven company.
Ready to Make an Impact? We encourage you to apply!
We have determined a salary range for this position that takes into account several factors including experience, knowledge, education, skills, and abilities. Please note that the salary information is a general guideline and the exact salary will be determined based on the individual's qualifications and experience, with consideration given to the factors listed above.
Expected Salary Range in Denver:
$55,000-$75,000
Frontera Health, Inc. is committed to creating and maintaining a diverse, equitable, and inclusive workplace where everyone feels valued, respected, and has the opportunity to thrive. We believe that our differences make us stronger and that all employees, regardless of their background, experiences, or abilities, contribute to our success.
We are committed to:
- Providing equal employment opportunities to all qualified individuals, without regard to race, color, religion, sex, national origin, disability status, sexual orientation, gender identity or expression, age, genetic information, veteran status, or any other characteristic protected by law.
- Fostering a culture of inclusion and belonging where everyone feels valued and respected.
- Providing reasonable accommodations to employees with disabilities.
- Continuously learning and improving our DE&I practices.
We will achieve this commitment by:
- Recruiting and hiring a diverse workforce that reflects the communities we serve.
- Creating and maintaining an inclusive work environment that is free from discrimination and harassment.
- Actively listening to and addressing the needs and concerns of all employees.
We believe that diversity, equity, and inclusion are essential to our success as a company and to our mission of serving the pediatric behavioral health community. We are committed to continuous improvement in this area and welcome feedback from all employees.
Salary : $55,000 - $75,000
