• Regularly dropping and submitting claims daily to insurance carriers for processing.
• Able to work claims and holds.
• Regularly monitors claims over 90-120 days old, and continually works older claims to resolve and process for payment.
• Performing individual account analysis for patients and answer patient billing questions.
• Assist with monitoring and actively collect on patient balances owed to practice.
• Tracking denial notifications and maintaining claims tracking system for denied claims.
• Billing private and commercial insurances such as Aetna, Anthem, Blue Shield, Cigna, Medicare, MHN, Tricare, Triwest, etc.
• Checking and monitoring patient insurance benefits prior to their first intake appointment and alerting patient of benefits.
• Creating and maintaining patient’s cards on file to ensure timely patient payments.
• Patient Collection on outstanding balances.
• Reviewing missing claims monthly with clinicians and ensuring timely submission of all claims.
• Reviewing EOB’s for payments and posting payments regularly.
• Reviewing payments and fee schedules to ensure proper reimbursement.
• Reviewing clinical documentation to ensure proper coding is submitted.

• Compiles and maintains current and accurate data for all providers.
• Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
• Maintains copies of current state licenses, certificates, malpractice coverage and any other required credentialing documents for all providers.
• Maintains knowledge of current health plan and agency requirements for credentialing providers.
• Sets up and maintains provider information in online credentialing databases and systems.
• Tracks license and certification expirations for all providers to ensure timely renewals.
• Ensures practice addresses are current with health plans, agencies and other entities.
• Audits health plan directories for current and accurate provider information.

• Maintains confidentiality of provider information.
• Provides credentialing and privileging verifications.
• Performs other duties as assigned.

• Previous Billing experience (3-5 years minimum) with primarily experience in Behavioral Health.
• Education Requirements: Associates Degree minimum.
• Proven reliability and great attendance.
• Well organized, attentive to details, and able to handle multiple expected tasks/deadlines.
• Previous use of Medisoft clearinghouse and Theranest preferred.
• Knowledge of Microsoft Office products.
• Ability to work remotely with attendance to staff meetings 2x a month in Oceansides/Carlsbad (remote)

• Sick Time/Mental Health Days.
• Heath benefits.
• 401K with company contribution.
• Time off on Federal Holidays.
• Bereavement.

Wave Therapy was established in 2014 by Mark Brewer, MFT, LPCC, in Carlsbad, CA. As an established Marriage and Family Therapist in Private Practice, Mark had a vision that by uniting some of the finest therapists and nurse practitioners together WAVE would be able to offer clients the highest level of compassion, support, and wisdom for self growth and improvement, as well as to enhance relationships in their lives. It has always been Mark’s vision to grow the practice and when the time was right, expand into new locations.