Boulder Care is looking for an Insurance Verification & Billing Support Specialist for a 100% remote, full-time position. Candidates must reside and work in one of the following states to be considered for the role: AZ, CO, FL, GA, ID, IL, MA, NC, NJ, NY, OH, OR, PA, TX, UT, WA, and WV

About us 

Founded in 2017, Boulder Care is a digital clinic offering long-term addiction treatment grounded in kindness, respect, and unconditional support. Our program is designed by addiction medicine specialists and people with lived experience of recovery. It is rooted in years of clinical expertise, proven research, and learnings from our participants.

Our mission is to improve the lives of people with substance use disorders. We provide the medication, resources, and support to help our participants succeed on their own terms, wherever they are in their journey.

Boulder Care is in an exciting stage of rapid growth, coming off a recent $35 million Series C round announced in May 2024, bringing total funds raised to roughly $85 million. Investors include Advance Venture Partners, First Round Capital, Laerdal Million Lives Fund, Qiming Venture Partners and Stripes, among others.

About this role

The Insurance Verification & Billing Support Specialist in coordination with the department supervisor, is responsible for overseeing the front end billing process for patients, to include eligibility verification and patient insurance updates. This role will  work closely with other teams to ensure quick resolution to eligibility issues, prior authorizations and other patient billing inquiries.

Success in this role

Essential Functions 90%

• Responsible for verifying insurance eligibility and benefits for all New Boulder commercial enrollments
• Conveying policy benefit and eligibility information to patients in a comprehensive and professional manner
• Assist the ES and CN team with difficult Insurance Verification or other barriers to validating the insurance details for enrollment or changes to established patients.
• May include helping to troubleshoot portals, etc. 
• Acts as first point of contact for Incoming ZenDesk patient messages and the Slack channel #insurance-questions,  pertaining to insurance and billing issues.
• Will maintain ongoing dated eligibility checks for accurate billing and clean claims
• Responsible for insurance eligibility verification for the Prior- Auth team as needed. 
• Collaboration with other Boulder teams to assist with patients who have lapsed coverage and need temporary “Boulder Assist” assigned. 
• Serves as SME for insurance training working to assist in new enrollment team onboarding. 
• Will work to help develop and maintain standard processes for keeping insurance data in the EHR accurate and up to date. 

Other Responsibilities 10%

• Other duties as assigned by Billing Leadership
• Identifying and correcting billing errors and resubmitting claims to insurance carriers
• Research/rectify third party denials/edits, requests for information and other related correspondence
• Act as a key contributor to the Revenue Cycle by identifying and reporting inefficiencies and opportunities that enhance revenue flow, decrease denials, and minimize write-offs

Qualifications

• 5+ years of experience in a healthcare setting specific to billing, and accounts receivable
• Ability to interpret and apply insurance payer billing guidelines, claim rules, and contract terms
• Proficiency in government, commercial and/or insurance payer claims follow-up, denial resolution, and appeals processes
• CPT and ICD coding knowledge 
• Knowledge of ANSI 837 and 835 files, including how to read and interpret
• Exceptional written and verbal communication
• Team-focused; effective collaboration. Serves both the team and the customer at a consistently high level
• Demonstrates problem-solving and analytical skills appropriate for the position
• Demonstrates high ethical standards of behavior
• Maintains composure under pressure
• Regularly demonstrates Boulder’s core values

Work environment

• This is a fully remote role but we are currently only hiring candidates located in the following states: AZ, CO, FL, GA, ID, IL, MA, NC, NJ, NY, OH, OR, PA, TX, UT, WA, and WV. Applicants must reside and work in one of those states to be considered. 

Expected hours of work

This is a full-time position expected to work 40 hours a week, M-F 9am-5:30pm Pacific Time (12pm-8:30pm Eastern Time). 

Hiring process

• First Interviews (30-min phone)
• Panel Interviews (45-min video)
• Tentative Start Date: Jan 27th, 2025

Compensation

The starting pay range for this position is $25.50 - $28.50 an hour, commensurate with experience, and is eligible for our comprehensive benefits package below.

Some of Boulder’s amazing benefits for regular, full-time employees

• Contribution to meaningful, life-saving work!
• Comprehensive medical, dental, vision, and short-term disability benefits designed to take care of our employees and their families 
• Mental Health Services including MDLive, Talkspace, and EAP
• 4 weeks of PTO accrued per calendar year with a tenured increase to 5 weeks at 2 years of employment
• Sick leave accrued at 1 hr for every 30 hrs paid
• 9 Paid Holidays per year
• 12 weeks of 100% paid parental leave for the birth or adoption of a child (after 6 months of employment)
• 401(k) retirement savings
• Remote friendly with hardware provided to complete your work duties

Our values

• The people we care for always come first
• Our opportunity is also our duty, in service to others
• Share facts to change minds, instill empathy to change hearts
• Move the industry forward: follow the data
• Strong individuals, stronger together
• Boulder Care recognizes the value that lived experience can provide to our organization, community, and patients. Applicants with lived experience and/or training as a peer recovery specialist are encouraged to apply.

Why work at Boulder?

• Make a difference. The devastating impact of the opioid crisis, “war on drugs,” and care gaps for the underserved are at the forefront now more than any time in US history. By bringing care to more people, we are changing and saving lives. Value-based partnerships help move the industry forward toward a more modern, compassionate, and equitable healthcare system.
• Build your career with talented peers. Boulder brings together a diverse team of expert clinicians, technologists, researchers, and business strategists aligned under a common mission. Boulder’s clinical teams are the leading voices in addiction medicine and industry transformation. Our technology leadership has built products and services that scaled to hundreds of employees and hundreds of millions of end-users. Our team is wholly driven by mission, recognizing that our immense opportunity is also our duty to serve others.
• Grow with us. Boulder is a Series-C-stage, venture-funded company supported by a world-class investor group. Together, we're building a breakthrough business through social impact. According to White House estimates, the annual societal cost due to opioid addiction is $1.5 trillion. A member with untreated opioid use disorder (OUD) drives 620% greater healthcare costs to payers than the average member (Optum analysis, 2017). Boulder partners with leading commercial and Medicaid health plans to bring better experiences and effective services to their members, significantly reducing costs and sharing in the economic savings we create.

Boulder Care believes the people who manage our product and team should be representative of those who use the platform. This includes people from backgrounds that are historically underrepresented in the industry. We celebrate differences and are committed to equal employment opportunities regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, citizenship, marital status, disability, gender identity or veteran status. If you are a qualified person with a passion for what we do, please apply!