Billing and Claims Support Representative

Zim Directory; New York (NY); Remote; USD 29,000 - 40,000; Full time

Benefits offered by this job

Medical, Dental and Vision coverage

HSA/FSA

401k with matching

Disability & life insurance

Pet insurance

Wellness stipend

PTO & remote-first environment

Team events

Talkspace access for you and household

Friends & family discount

Job summary

Talkspace is seeking a Billing and Claims Support Representative to join our Customer Support team. This remote ET-based role educates clients on billing and claims procedures with empathy, handling escalations and supporting process improvements to enhance productivity and client satisfaction.

You will work with payors, draft superbills on request, and collaborate with internal stakeholders as a claims SME to ensure accurate, timely responses and updates for our members.

Qualifications

• 2+ years experience with health insurance claims or support environment, required; preferably in a phone/email/chat support-related capacity.
• Knowledge of Behavioral Health terminology (ie CPT Codes) and understanding of Insurance benefits.
• Knowledge of PHI and HIPAA guidelines when working with sensitive material.
• Experience in the tele-health, tele-therapy, medical insurance industries is a plus.
• Familiarity working within payor portals; Zendesk, Atlassian (Jira, Confluence) is a plus.

Responsibilities

• Educate Talkspace clients on billing and claims procedures and respond to escalated service-related billing inquiries.
• Resolve complex inquiries with empathy, ensuring clients feel cared for and supported.
• Participate in department projects to improve client experience, including charge disputes and billing affidavits.
• Conduct outbound calls to payors to discuss claim submissions as needed.
• Draft and provide superbills to clients when requested.
• Serve as claims SME and collaborate with internal stakeholders on billing and claims projects.
• Work closely with Client Support to provide status updates on payer issues and assist with escalations.
• Provide white glove service to all members and follow up to ensure resolution.
• Stay updated with business updates to ensure accurate assistance.
• Identify client contact trends and report issues to leadership.

Skills

Health insurance claims

Phone support

Email support

Chat support

Behavioral Health terminology

HIPAA compliance

Payor portals

Tools

Zendesk

Jira

Confluence

Job description

Headquarters: New York, NY (Remote)

At Talkspace, we are committed to fostering a diverse, equitable, inclusive, and belonging-centered workplace where everyone can thrive while making a difference in mental health. Want to help over two million people receive quality mental healthcare? Come join our mission of getting therapy in the hands of everyone!

We are looking for an experienced Billing and Claims Support Representatitve to join our Customer Supportteam. This role would be responsible for educating clients on our billing and claims procedures, swiftly addressing escalated inquiries with empathy and accuracy. We are looking for someone who has experience providing white-glove service to our clients, ensuring they feel cared for and supported in every interaction. You’ll also contribute to process improvement initiatives, recommending updates to knowledge materials and suggesting improvements to support processes, all aimed at enhancing productivity and client satisfaction. To work at Talkspace, you need to be as passionate as we are about our work, and excited to partner with us on delivering quality mental healthcare.

This is a remote position based on Eastern Time. Talkspace Headquarters is located in NYC.

What You’ll Do

Client Experience

• Use internal knowledge materials + resources to educate Talkspace clients on our billing and claims procedures, and quickly and accurately respond to escalated service-related billing inquiries from existing members, including but not limited to questions related to enrollment errors, refund requests, claims adjustments, superbill requests, etc.
• Resolve complex and/or escalated inquiries that require investigation and a high degree of empathy, ensuring every interaction with Talkspace leaves our clients feeling cared for, understood and supported.
• Participate in non-inbound volume related department operations speciality projects aimed to further support our clients in their full journey at Talkspace, ie.
  • Charge disputes
  • Medical records request for billing records
  • Billing affidavits (written and verbal)
• Conduct outbound calls to payors, obtain member EAP authorization, and discuss claim submissions on a case by case basis.
• Draft and provide superbills to clients when requested, as needed.
• Serve as company claims SME and collaborate with internal stakeholders on billing and claims-related ad hoc projects, as assigned.
• Work closely with our Client Support team, providing status updates on known payer issues and assisting with client escalations, as needed.
• Provide white glove service to all our members, infusing empathy and kindness in all replies, and following up with clients when necessary to ensure resolution.
• Keep up with business updates to ensure the assistance provided is accurate and up to date.
• Identify client contact reason trends and roll up any potential issues affecting a specific segment of clients to leadership daily, as needed.

Documentation + Process Improvement

• Contribute to the improvement of our department by suggesting updates to departmental knowledge materials + resources (internal knowledge base, correspondence templates).
• Recommend changes to existing support processes and/or implementation of new standard processes aimed at improving productivity, job satisfaction, and our client experience.

Team Collaboration

• Serve as onboarding buddy to department new hires and participate in onboarding training as SME, as needed.
• Attend all department meetings (ie. coaching sessions, recurring 1:1s, ongoing training lessons), as scheduled.
• Maintain regular communication with your Supervisor and team, daily.

Performs other related duties as assigned.

About You

• 2+ years experience with health insurance claims or support environment, required; preferably in a phone/email/chat support-related capacity.
• Knowledge of Behavioral Health terminology (ie CPT Codes) and understanding of Insurance benefits ( ie: copy, coins and deductible), required.
• Knowledge of and ability to comply with PHI and HIPAA guidelines when working with sensitive material, required.
• Experience in the tele-health, tele-therapy, medical insurance industries is a plus.
• Familiarity working within payor portals, third party healthcare clearinghouses, required; Zendesk, Atlassian (Jira, Confluence) is a plus.

Bonus Points

• Experience working in a provider’s office or health insurance company

Benefits

• Comprehensive Medical, Dental and Vision plans
• Pre-tax benefits: HSA/ FSA
• 401k Retirement Savings Program with matching
• Voluntary benefits including disability, basic life or pet insurance, etc.
• Monthly Wellness Stipend to promote mental and physical self-care
• PTO and Remote First Environment
• Regular team events, including Wellness Workshops and Team Building Events
• Free access to Talkspace products for you and one household member, as well as access to a friends and family discount!

Compensation

At Talkspace, we believe that pay transparency during the interview process is a critical part of diversity, equity, and inclusion. Our salary bands are based on internal and external compensation benchmarks, which we regularly evaluate to ensure we pay competitively.

The hourly rate for this role is $24.50/hr.

Why Talkspace?

Talkspace is the world’s leading online therapy company, serving over 2 million users looking to begin their wellness journey through tele-health. According to the World Health Organization, close to 1 billion people worldwide live with a mental disorder, and on average more than 75% with mental, neurological, and substance use disorders receive no treatment for their condition at all. Additionally, one-third of the world’s population – 2 billion people – live in countries that spend less than 1% of their health budgets on mental health. Therapy is an universal need and it’s our mission here to change the world by cultivating an intentional space for people to feel supported through quality care that is simple and accessible.

Combining our passion for innovation along with our desire to help others overcome the stigma behind “getting help,” we are transforming the way patients find the right care provider, making an otherwise impossible feat easily conquerable. Our network of licensed, accredited, and board-certified clinicians are increasing access to mental health for our members through a myriad of high quality therapy services: anytime and for a fraction of the price. Dedicated to our mission, we are looking for candidates that want to bring their talents into a diverse “for purpose” space. If you’re equally as passionate about making quality mental healthcare accessible to all then Talkspace is the right place for you!

EQUAL OPPORTUNITY EMPLOYER

Talkspace welcomes and celebrates talent from all backgrounds, perspectives, and walks of life to foster an innovative and diverse workforce. We encourage you to apply, even if you don’t meet every qualification or if your path has been nontraditional — such as not completing a formal degree program, taking a career break, or having a prior criminal record — if you believe you could make a great addition to this team. Come as you are and learn about the exciting opportunities on our team.

Individuals seeking employment at Talkspace are considered without regard to race, color, religious creed, sex, national origin, citizenship status, age, physical or mental disability, sexual orientation, marital, parental, veteran or military status, unfavorable military discharge, or any other status protected by applicable federal, state or local law.

How do we define Diversity, Equity, Inclusion, and Belonging at Talkspace?

Diversity

Diversity encompasses the unique attributes of our employees as individuals. We value and embrace the richness arising from their varied backgrounds, perspectives, and experiences, which include, but are not limited to, age, ability, ethnicity, gender, race, and cultural background.

Equity

Equity refers to a fair and impartial workplace, aiming to ensure equal growth and advancement opportunities for all employees. This involves amplifying underrepresented voices, addressing unconscious biases, and providing inclusive, culturally competent mental health care.

Inclusion

Inclusion signifies the practice of granting equal access to opportunities and resources for all employees, particularly those who might otherwise be excluded or marginalized. It ensures that everyone feels a sense of belonging, value, and support, as an individual.

Belonging

Belonging reflects the affinity and positive relationships that develop among employees from diverse backgrounds when businesses actively promote diversity, equity, and inclusion in the workplace.