Job Description:

Job Title: Claims SpecialistLocation: Kirksville, MODepartment: BillingEmployment Type: Full TimeShift: Monday - Friday

Job Summary: Are you a passionate and dedicated professional looking to make a positive impact in the lives of individuals dealing with Substance Use Disorder and Behavioral Health issues? Join our team at Preferred Family Healthcare as a Claims Specialist!

As a Claims Specialist, you'll analyze trends in data, report findings to leadership, and ensure the accuracy of insurance billing processes. Our ideal candidate is passionate about data analysis, has experience in insurance claims, and possesses strong communication and teamwork skills.

Kirksville, MO offers a variety of events and activities to choose from. Whether it’s visiting the state park, stopping by the farmers market, being engaged in the college and universities, or enjoying community events and businesses. Join us!

Position Perks & Benefits:

• 29 Days of PTO

• Competitive Pay

• Employee benefits package - health, dental, vision, retirement, life, & more**

• Competitive 401(k) Retirement Savings Plan – up to 5% match for Part-Time and Full-Time employees

• Company-paid basic life insurance

• Emergency Medical Leave Program

• Flexible Spending Accounts – healthcare and dependent child-care

• Health & Wellness Program

• Employee Assistance Program (EAP)

• Employee Discount Program

• Mileage Reimbursement

Key Responsibilities:

Insurance Billing & Claim Analysis:

• Knowledge and Understanding: Possess knowledge of insurance billing processes and demonstrate a strong understanding of claim data and analytics.

• Data Research and Assessment: Research and assess claim data for quality and accuracy, preparing and maintaining reports from various data sources.

• Data Analysis and Communication: Analyze trends in data and effectively communicate findings to leadership.

Teamwork & Attention to Detail:

• Teamwork Skills: Exhibit strong teamwork skills and the ability to complete tasks and projects effectively with minimal support.

• Adaptability: Remain sensitive to changing needs, organizing and prioritizing tasks based on current requirements.

Data Management:

• Knowledge Maintenance: Maintain knowledge of the organization’s claim data and billing practices, continuously striving to improve data collection methods.

Professionalism & Ethics:

• Operational Standards: Function according to Operational Guidelines and uphold a professional code of ethics.

• Development and Engagement: Participate in team member development activities, demonstrating sensitivity and responsiveness to management needs.

• Program Engagement: Engage in program evaluation, grant applications, contract maintenance, and participate in required meetings and self-evaluation.

Other Duties:

• Perform additional duties as assigned.

Education and/or Experience Qualifications:

• Two years applicable experience required.

• Bachelor’s Degree in related field preferred.

Additional Qualifications:

• Independent Work & Problem-Solving:

• Perform tasks independently or with minimal support.

• Experience in solving basic to complex issues.

• Technical Skills:

• Proficient in technical writing (queries, reports, visualizations).

• Moderate understanding of claim data and analytics.

• Identify data patterns and inconsistencies.

• Proficient in Microsoft Suite products.

• Power user in Excel.

• Experience with SQL, Tableau, Crystal, or similar business analytics programs preferred.

• Communication & Presentation:

• Excellent communication skills.

• Clear and direct communication about technical subjects.

• Effective presentation skills.

• Communicate effectively with a wide range of stakeholders.

• Basic Math & Documentation:

• Read and interpret safety rules, operating instructions, and procedure manuals.

• Perform basic arithmetic operations (add, subtract, multiply, divide).

• Instruction & Problem-Solving:

• Follow written, oral, or diagram instructions.

• Address problems with several concrete variables in standardized situations.​

• Additional Skills:

• Excellent problem-solving abilities.

• Accept supervision and follow directions effectively.

Brightli is on a Mission:A mission to improve client care, reduce the financial burden of community mental health centers by sharing resources, a mission to have a larger voice in advocacy to increase access to mental health and substance use care in our communities, and a mission to evolve the behavioral health industry to better meet the needs of our clients.

As a behavioral and community mental health provider, we value diversity, equity, and inclusion in our workforce and encourage applications from individuals from diverse backgrounds and experiences. If you are passionate about empowering your local communities and promoting health equity, we invite you to join our mission-driven organization that is committed to building a diverse, equitable, inclusive and authentic workplace.

We are an Equal Opportunity and Affirmative Action Employer, and encourage applications from all qualified individuals without regard to race, color, religion, sex, gender identity, gender expression, sexual orientation, national origin, age, marital status, disability or veteran status, or to other non-work related factors.

Preferred Family Healthcare is a Smoke and Tobacco Free Workplace.

About Brightli

Brightli is on a mission: A mission to improve client care, reduce the financial burden of community mental health centers by sharing resources, a mission to have a larger voice in advocacy to increase access to mental health and substance use care in our communities, and a mission to evolve the behavioral health industry to better meet the needs of our clients. We are doing this by forming a new behavioral health organization under new model. Under one parent company, multiple organizations are able to collaborate, share resources and system supports, increase recruiting and retention efforts, increase access to specialized care, and meet the growing demand for behavioral and addiction recovery care.

Brightli’s top-line subsidiaries include Burrell Behavioral Health (Burrell), Preferred Family Healthcare (PFH), Southeast Missouri Behavioral Health (SEMO), Firefly, Adult and Child Health, and Places for People. While these organizations operate independently and are governed by separate board of directors, their operations and services benefit from this model. Alone, organizations may be able to navigate the current tumultuous healthcare environment, but we believe that together we can do so much more than survive. Our communities need us now more than ever, and by working together we are ready to answer their call for years to come.

Brightli Snapshot

• 200 locations

• 4 states

• 19 subsidiaries and/or affiliates

• 5k+ employees