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Job Description Job Summary Prior Authorization TeemaGroup Full-time In-Office | White Plains, NY, United States Overview: The Prior Authorization & Billing Specialist plays a critical role in ensuring timely access to mental health services by managing insurance authorizations, billing processes, and reimbursement workflows. This position serves as a key liaison between clinical teams, insurance payers, and patients, ensuring services are authorized, accurately billed, and compliant with regulatory and payer requirements. This role is ideal for a detail-oriented professional passionate about supporting behavioral health access through strong administrative and revenue cycle expertise. What you will be doing: Prior Authorization & Utilization Management Obtain and manage prior authorizations for outpatient and inpatient mental health services, including therapy, psychiatry, psychological testing, and intensive programs. Review clinical documentation to ensure medical necessity and payer compliance. Submit authorization requests to insurance companies via portals, phone, or electronic systems. Track authorization approvals, denials, expirations, and extensions; proactively follow up to prevent treatment delays. Communicate authorization status clearly with clinicians, scheduling staff, and leadership. Assist with peer-to-peer reviews and appeals when authorization is denied or partially approved. Billing & Revenue Cycle Support Submit accurate and timely claims for mental health services to commercial, Medicaid, and Medicare payers. Verify insurance eligibility, benefits, and coverage limitations prior to services. Review Explanation of Benefits (EOBs) and remittance advice for accuracy. Identify, research, and resolve claim denials, underpayments, and rejections. Post payments and adjustments accurately when applicable. Maintain compliance with CPT, ICD-10, and modifier guidelines specific to behavioral health billing. Administrative & Compliance Responsibilities Maintain accurate patient authorization and billing records within electronic health record (EHR) and billing systems. Ensure compliance with HIPAA, payer contracts, and internal policies. Collaborate with clinical, administrative, and finance teams to optimize workflows and reduce revenue leakage. Monitor payer requirements, policy changes, and authorization rules related to mental health services. Prepare reports related to authorization turnaround times, denial trends, and billing performance. Perform other related duties as assigned. What you must have: Education and Experience High school diploma or equivalent required; associate or bachelor’s degree in healthcare administration or related field preferred. Minimum of 2 years of experience in prior authorization, utilization review, medical billing, or revenue cycle operations. Experience in mental health or behavioral health services strongly preferred. Knowledge, Skills, and Abilities Strong understanding of prior authorization processes and insurance requirements. Knowledge of behavioral health billing practices, CPT and ICD-10 coding, and payer guidelines. Excellent attention to detail and organizational skills. Ability to manage multiple priorities in a fast-paced environment. Strong written and verbal communication skills, including professional interaction with payers and clinical staff. Ability to work independently while collaborating effectively with a team. Proficiency with EHR systems, billing software, and Microsoft Office applications.

Job DescriptionBenefits: • 401(k), • Competitive salary Medical Billing HOME HEALTHCARE Specialist /Office Personnel KLS Healthcare KLS Healthcare is seeking an experienced and detail-oriented Medical Billing Specialist to join our growing team of home care professionals. This role is responsible for managing billing, collections, and third-party reimbursement processes while ensuring accuracy and compliance, and is NOT limited to regular office staff duties. Key Responsibilities • Accurately enter charges, payments, and adjustments into the billing system and review batches for accuracy, • Verify patient demographics, insurance coverage, coding, and payment allowances, • Prepare and submit claims and correspondence to insurance carriers and patients for reimbursement, • Respond to telephone inquiries, audits, and written correspondence related to accounts receivable, • Establish payment arrangements with patients as needed, • Maintain organized billing files and documentation, • Track and maintain daily, weekly, and monthly fee collection records, • Perform other office-related duties as assigned Qualifications • Prior experience with third-party insurance billing required, • Strong attention to detail and organizational skills Ability to manage multiple tasks in a fast-paced healthcare environment • Excellent communication and customer service skills, • Knows Medical Billing Codes Compensation Additional Salary Information: The salary range and/or hourly rate listed reflects a good-faith estimate of potential base compensation at the time of posting and may be adjusted in the future. Compensation is determined based on factors such as location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget, and internal equity.

Job Description Determine initial eligibility and benefits for applicant · Determine if any pre-authorization or pre-certification is required under their benefit plan for the SUD related services · Enter authorization tracking received from Chief Clinical & Health Officer in Insync. · For insured patients, Billing Specialist will perform a pre-service eligibility & benefits review including a determination of pre-authorization needs and/or admission notification requirements as applicable prior their 1st appointment. o Will prepare a Financial Agreement for the patient and distribute the agreement to the front desk staff for signature at check-in for their 1st appt. o Will notify the Chief Clinical & Health Officer of any required pre-auth or admission notice prior to the 1st appointment date and will facilitate informing and assisting the clinician with the pre-auth or admit notice process. · Meet in person prior to the first Assessment appointment for financial counseling when after pre-screening the patient that may be eligible for a nominal fee (uninsured-undocumented) or a sliding scale (uninsured-underinsured) agreement. · Review on a daily basis the batch eligibility reports generated in Insync 3-4 business days before their schedule appointment and contact any client that is found to be ineligible at that time so-as-to-be able to: o Obtain new insurance information and perform eligibility/benefit check or; o To facilitate enough time for the client to recertify their Medicaid benefits prior to the date of the scheduled service or Pay out of pocket for the services until recertification application proof has been supplied. o Review Date of Service eligibility report and notify front desk of any clients that are found to be ineligible on their date of service prior to their appointment time. o Perform the review of charges generated by the providers daily to ensure correct coding o Reach out to providers with any questions regarding their coding of services Monitor services date to charges reporting to ensure all services rendered have been submitted for billing within 48 hrs. of service date (business days) Monitor the Millin issue tracker daily and respond and correct information for claims that have been denied · Monitor outstanding AR reporting for unpaid claims, incorrectly paid claims, incorrect balances and rebill/resubmit claims coordinating as appropriate coordinating with the Millin account representative · Generate the appropriate monthly AR reports (to be defined) for management staff · Assist the front desk and clinical staff with any questions they may have related to billing, payment and eligibility as appropriate · Act as resource and mentors all staff and management on billing, coding and related questions that arise. · Assist Chief Clinical & Health Officer regarding any clinical or office related matters that she may request. · Management of the Assessment Tracker to monitor no shows, cancelations and rescheduling of assessments. Company DescriptionWe provide full-service Healthcare Recruitment solutions. We identify, attract, engage, and connect the best possible talent with quality healthcare professionals. We build teams, provide executive recruitment solutions and discover high-performance candidates on behalf of our client partners. Our strength lies in our proven recruitment strategies, leadership in the larger healthcare community (regional and national), and networking.We provide full-service Healthcare Recruitment solutions. We identify, attract, engage, and connect the best possible talent with quality healthcare professionals. We build teams, provide executive recruitment solutions and discover high-performance candidates on behalf of our client partners. Our strength lies in our proven recruitment strategies, leadership in the larger healthcare community (regional and national), and networking.

Job Description Transitional Services for New York, Inc., (TSINY) not-for profit, is a comprehensive, community-based mental health organization located in New York City. We provide a continuum of rehabilitative services to enrich the lives of those recovering from mental illness and facilitate their transition to increased levels of independence. Transitional Services for New York, Inc. envisions broadening its rehabilitative services and becoming a regional social service provider. Transitional Services for New York Staff will deliver effective programs with compassion, integrity, and professionalism. We expect all staff to put our clients’ needs first while respecting each other and ourselves as we provide hope to those who participate in our programs. TSINY is looking for Training & Development Specialist for our Corporate Compliance department located in Whitestone (Queens), NY. Position may require travel to sites in Queens, Brooklyn, Manhattan and the Bronx. Salary: $75,000 annually, Exempt, Full-Time Full Benefits: Medical, Dental, Vision, 403b, Pension, Life Insurance Position Summary The Training and Development Specialist is responsible for implementing and tracking TSINY’s internal training infrastructure. The Specialist provides administrative, technical and support for all training-related functions. Essential Functions • Coordinate scheduling and coordination for monthly orientation sessions and Agency trainings (PFS, RC, DEI, etc.), • Run monthly Relias reports to track training compliance and notify leadership of gaps or overdue items., • Assist with the implementation and dissemination of annual training calendar and staff communications., • Update and maintain Relias training platform (enrollments, completions, schedules, etc.)., • Distribute monthly RC Champions curriculum and schedule related sessions as directed., • Track instructor certifications (RC, PFS)., • Provide documentation support for internal or external audits of training records., • Facilitate individualized trainings required due to corrective actions., • Coordinate internship scheduling and placements in collaboration with leadership and partner schools., • Maintain digital files and assist in policy updates related to training compliance requirements., • Member of Incident Review Committee, • Conduct annual refresher training for incident reporting and compliance issues., • Follow up with staff who do not show up for orientation., • Assume responsibility for providing training to staff on refresher topics like Partnering for Safety techniques or trauma informed care principles at staff meetings., • Provide direct training for new staff on the basic use of Agency technology, including AWARDS, Outlook, Zendesk, Office 365, preferably by developing a standardized model., • Report incidents to the Justice Center and New York State Office of Mental Health., • Investigate allegations of consumer abuse and neglect., • Audit insurance claims for compliance with requirements and regulations., • Audit all programs for adherence to operating regulations., • 24/7 on call for serious incidents, • Policy and Procedure development., • Monitor Agency compliance program., • Participate in ongoing development of compliance program., • Chair the Staff Development Committee and monitor and coordinate Agency staff development efforts., • Be able to sit or stand as needed, with or without reasonable accommodation., • May require walking, primarily on a level surface, for short periods throughout the day, with or without reasonable accommodation., • Be able to reach above shoulder heights, below the waist or lift as required to file documents or store materials throughout the workday, with or without reasonable accommodation., • Be able to lift items up to 25 pounds., • During a declared disaster, assume and adhere to assigned Job Action role(s) consistent with Disaster Preparedness Plan., • Perform other related duties as required. The ideal candidate will: • be detailed oriented., • be able to work independently and take initiative., • have the ability to multi-task and meet deadlines., • possess effective oral and written communication skills., • have the ability to interact effectively with all levels of employees, as well as external contacts., • be able to handle confidential and sensitive information., • require manual dexterity for the use of a computer, telephone, fax, or copy machine., • be able to prepare clear, concise reports., • possess knowledge of the needs of consumer populations and treatment sources., • be able to plan, assign and direct the work of others., • be able to communicate effectively both orally and in writing., • support the mission, values and vision of the organization., • promote positive public relations with residents, family members and guests., • complete requirements for in-service training, acceptable attendance, uniform and dress codes, including personal hygiene., • be able to solve complex problems and deal with a variety of issues., • possess the ability to effectively present information and respond to questions from managers, employees, residents, families, professionals and the general public., • possess the ability to communicate sensitive information to principals and consumers. Experience/Education/Skills/Abilities Bachelor’s degree required, Master’s preferred, 3 years’ compliance, training and clinical experience with psychiatric population. TSINY is an equal opportunity employer that is committed to a policy of nondiscrimination in accordance with Title VII of the Civil Rights Act, as well as the New York State Human Rights Law. TSINY prohibits discrimination against any employee or applicant for employment on the basis of race, creed, color, national origin, sex, gender, age, disability, marital status, sexual orientation, citizenship status, veteran status or other protected group status as provided by law in all employment decisions.

Job Description Transitional Services for New York, Inc., not-for profit, is a comprehensive, community-based mental health organization located in New York City. We provide a continuum of rehabilitative services to enrich the lives of those recovering from mental illness and facilitate their transition to increased levels of independence. Transitional Services for New York, Inc. envisions broadening its rehabilitative services and becoming a regional social service provider. Transitional Services for New York Staff will deliver effective programs with compassion, integrity, and professionalism. We expect all staff to put our clients’ needs first while respecting ourselves and each other as we provide hope to those who participate in our programs. TSINY, a non-profit mental health services agency is seeking a Full-Time Corporate Compliance Specialist for its Administrative offices in Whitestone, NY. Annual Salary: $66,300; Exempt Full-Time The Corporate Compliance Specialist will ensure the Agency is in compliance with all Federal, State, and City laws, regulations, and Agency policies. They will be responsible for conducting compliance and quality assurance audits. Essential Functions: • Member of Incident Review Committee, • Report incidents to Justice Center and New York State Office of Mental Health., • Investigate allegations of client abuse and neglect., • Audit insurance claims for compliance with requirements and regulations., • Provide training for staff and directors., • Audit all programs for adherence to operating regulations., • 24/7 on call for serious incidents., • Policy and Procedure development., • Monitor Agency compliance program., • Participate in ongoing development of compliance program., • HIPPA Privacy Officer duties., • Participate in the Staff Development Committee and Agency staff development efforts., • Coordination of Staff Orientation., • Monitor AWARD Helpdesk and Zendesk., • Be able to sit or stand as needed, with or without reasonable accommodation., • May require walking, primarily on a level surface, for short periods throughout the day, with or without reasonable accommodation., • Be able to reach above shoulder heights, below the waist or lift as required to file., • Documents or store materials throughout the workday, with or without reasonable accommodation., • During a declared disaster, assume and adhere to assigned Job Action role(s) consistent with Disaster Preparedness Plan., • Perform other related duties as required. Requirements/Experience/Skills/Abilities BA/BS degree and 3-5 years' administrative, supervisory and clinical experience with psychiatric population. Evidence of progressively responsible positions is desirable. TSINY is an equal opportunity employer that is committed to a policy of nondiscrimination in accordance with Title VII of the Civil Rights Act, as well as the New York State Human Rights Law. TSINY prohibits discrimination against any employee or applicant for employment on the basis of race, creed, color, national origin, sex, gender, age, disability, marital status, sexual orientation, citizenship status, veteran status or other protected group status as provided by law in all employment decisions.

Job DescriptionJob Title: Workers' Compensation Specialist - NYSIF Safety GroupsLocation: White Plains / Irvington / NY Salary Range: $150,000 to $200,000 (Based on Experience) We are looking for an experienced and detail-oriented Workers' Compensation Specialist to join our team! In this role, you will manage and optimize our participation in New York State Insurance Fund (NYSIF) Safety Groups. These programs help employers with similar operational hazards pool their workers' compensation costs, potentially lowering premiums and providing dividends through improved safety practices and risk management.If you have a strong background in workers' compensation claims, risk management, and safety practices, we’d love to hear from you! Key Responsibilities: • Manage the enrollment and ongoing participation of clients in NYSIF Safety Groups., • Collaborate with employers to assess hazards and implement strategies to improve workplace safety., • Oversee the management of workers' compensation claims, ensuring timely and accurate processing., • Assist clients in lowering their workers' compensation premiums through effective risk management strategies., • Analyze data, prepare reports, and present findings to clients to demonstrate the value of NYSIF Safety Groups., • Provide education and support to clients on best practices for minimizing risks and managing workers' compensation claims., • Work with underwriters and insurance brokers to ensure optimal outcomes for Safety Group participants., • Stay up-to-date on state and federal workers' compensation regulations to ensure compliance.Qualifications:, • Bachelor's degree in Risk Management, Insurance, Business Administration, or a related field (preferred)., • Minimum of 5 years of experience in workers' compensation, safety management, or risk management., • Strong knowledge of NYSIF Safety Groups and New York State workers' compensation regulations., • Proven ability to assess workplace hazards and implement safety programs to mitigate risk., • Excellent communication skills and the ability to build strong relationships with clients and industry professionals., • Strong analytical skills and the ability to interpret complex data to drive strategic decisions., • Certification in Workers' Compensation or Risk Management (preferred). Why Join Us? • Competitive salary ranging from $150,000 to $200,000 based on experience., • Comprehensive benefits package, including health, dental, and vision insurance, retirement plans, and generous paid time off., • Opportunity to work in a dynamic and collaborative environment with room for career growth. Feel free to email your resume directly to swhite@aprcareers.com

Note : This is an educational program, not a job. Successful completion of the program does not guarantee employment but will equip you with valuable skills for the healthcare job market. Looking to start a rewarding career path in the healthcare industry? Use Dreambound to find a Medical Billing and Coding program that will prepare you for this high-demand, entry-level role. What does a Medical Billing and Coding Specialist do? A medical billing and coding specialist processes and codes healthcare claims to ensure accurate billing and insurance reimbursement, supporting the financial operations of healthcare facilities. Highlights : • Complete in as short as a few weeks to a few months, • Online and in-person options available, • Payment plans and financial aid may be available for those who qualify Cost : This program is an educational opportunity that requires a financial investment. Cost varies per partner school, but payment plans and / or financial aid may be available to those who qualify. Take the first step towards your new career path today!

The SIU Specialist must use their extensive knowledge of Insurance policies and the components of fraud to determine If claims warrant reporting to the appropriate state agency for prosecution. Acquire and gather information through use of own discretion, and guidance from clients and case managers,

SSA's Claims Technical Expert (CTE).SSA's Claims Technical Expert (CTE) is responsible for developing and adjudicating the most complex, non-routine Title II and/or Title XVI cases and on public fraud issues in specific claims and post-entitlement cases.The incumbent provides a lead role in technica

Interagency Career Transition Assistance Program (ICTAP) eligibles only in the commuting area of the selected duty location.Location: This position is located in the various offices within the Social Security Administration.Tour of Duty: Multiple work schedules (up to 40 hours).Alternative work sche

SSA's Claims Technical Expert (CTE). SSA's Claims Technical Expert (CTE) is responsible for developing and adjudicating the most complex, non-routine Title II and/or Title XVI cases and on public fraud issues in specific claims and post-entitlement cases. The incumbent provides a lead role in techni

Atlas Air is seeking an Insurance Specialist in White Plains, NY, responsible for managing insurance coverages, claims processing, and vendor relations.You will ensure compliance with policies while working with brokers to secure favorable terms for the company.The ideal candidate has 2-3 years of i