The Commercial Medical Biller is responsible for accurate and timely billing of hospital and Rural Health Clinic (RHC) claims to commercial insurance payers. This role focuses heavily on denial management, claim follow-up, and reimbursement optimization while ensuring compliance with payer contracts, federal regulations, and internal policies. Key Responsibilities Billing & Claims Submission - Prepare, review, and submit hospital and RHC claims to commercial insurance carriers. - Ensure correct use of CPT, HCPCS, ICD-10, revenue codes, modifiers, and RHC-specific billing requirements. - Verify charges, units, dates of service, provider credentials, and place of service. - Submit corrected, adjusted, and late charges as needed. Denial Management - Analyze and resolve billing denials, rejections, and underpayments. - Identify root causes of denials (coding, authorization, eligibility, medical necessity, bundling, timely filing, etc.). - Prepare and submit corrected claims and formal appeals with appropriate documentation. - Track denial trends and recommend process improvements to reduce future denials. Insurance Follow-Up - Conduct timely follow-up with commercial payers on unpaid, underpaid, or delayed claims. - Communicate with insurance representatives to obtain claim status and resolution. - Maintain detailed notes and documentation in the billing system for all follow-up activity. - Meet productivity and follow-up benchmarks to ensure timely reimbursement. Compliance & Collaboration - Ensure compliance with payer guidelines, hospital policies, and RHC billing regulations. - Work closely with coding, registration, authorization, and clinical staff to resolve billing issues. - Stay current on commercial payer policy updates and RHC billing changes. Required Skills & Qualifications - Knowledge of hospital and RHC billing processes. - Strong experience with commercial insurance billing and denial resolution. - Proficiency in CPT, ICD-10-CM, HCPCS, and modifiers. - Familiarity with payer portals and claim management systems. - Strong analytical, organizational, and follow-up skills. - Ability to manage high-volume workloads with attention to detail. Business Support

At Horizon Blue, we're building something different in ABA. We believe BCBAs should have the time and space to actually show up for families, not just manage caseloads. Our team works with 8-10 families, collaborates weekly, and helps guide the RBTs supporting kids daily. The work is thoughtful, present, and focused on what each child actually needs. Now we're opening a virtual branch in Maryland, and we need someone to help build it from the ground up. This is a chance to shape what ABA care can look like when it's done right. If you hold both NY and MD licenses, you can step in now. If you hold only an MD license, you'll be part of launching the branch and welcoming our first Maryland families. Either way, you'll have the support of our team and the freedom to focus on the work that matters: adjusting programming as kids grow, supporting parents through the hard moments, and coaching RBTs to show up well every day. BCBA (MD/NY) Requirements & Responsibilities - Master’s Degree in Applied Behavior Analysis or related field - Board Certified Behavior Analyst (BCBA) required - MD Licensed Behavior Analyst required - MD Medicaid ID required - NY Licensed Behavior Analyst preferred (for immediate start) - Medicaid ID from New York State preferred (for immediate start) - 1+ years of experience in ABA with a preference for having remote-based experience - Preference for Bilingual BCBAs in English & Spanish - Develop and oversee individualized ABA treatment plans. - Supervise RBTs and provide ongoing training and support. - Conduct assessments and adjust treatment goals as needed. - Collaborate with families and multidisciplinary teams to ensure client success. - Maintain compliance with ethical and regulatory standards. BCBA Benefits & Schedule: - Flexible Scheduling and Case Assignment - 100% Remote - Competitive W2 Compensation - If licensed in MD only: $85/hour - If licensed in both NY & MD: $60k base for 15 hours per week in billables, then $80-$90/hour for hours above 15 hours per week in billables. - Offers BOE $80 - $90 an hour

At Horizon Blue, we're building something different in ABA. We believe BCBAs should have the time and space to actually show up for families, not just manage caseloads. Our team works with 8-10 families, collaborates weekly, and helps guide the RBTs supporting kids daily. The work is thoughtful, present, and focused on what each child actually needs. Now we're opening a virtual branch in Maryland, and we need someone to help build it from the ground up. This is a chance to shape what ABA care can look like when it's done right. If you hold both NY and MD licenses, you can step in now. If you hold only an MD license, you'll be part of launching the branch and welcoming our first Maryland families. Either way, you'll have the support of our team and the freedom to focus on the work that matters: adjusting programming as kids grow, supporting parents through the hard moments, and coaching RBTs to show up well every day. BCBA (MD/NY) Requirements & Responsibilities - Master’s Degree in Applied Behavior Analysis or related field - Board Certified Behavior Analyst (BCBA) required - MD Licensed Behavior Analyst required - MD Medicaid ID required - NY Licensed Behavior Analyst preferred (for immediate start) - Medicaid ID from New York State preferred (for immediate start) - 1+ years of experience in ABA with a preference for having remote-based experience - Preference for Bilingual BCBAs in English & Spanish - Develop and oversee individualized ABA treatment plans. - Supervise RBTs and provide ongoing training and support. - Conduct assessments and adjust treatment goals as needed. - Collaborate with families and multidisciplinary teams to ensure client success. - Maintain compliance with ethical and regulatory standards. BCBA Benefits & Schedule: - Flexible Scheduling and Case Assignment - 100% Remote - Competitive W2 Compensation - If licensed in MD only: $85/hour - If licensed in both NY & MD: $60k base for 15 hours per week in billables, then $80-$90/hour for hours above 15 hours per week in billables. - Offers BOE $80 - $90 an hour

• Monitor executions of robots and automations in the production environment • Monitor logs, queues, and schedules • Identify failures, errors, and execution interruptions • Perform basic corrective actions (restart, reprocessing, rerun) • Record incidents in an ITSM tool • Escalate to the technical team when necessary • Ensure compliance with operational SLAs • Support audits and operational controls • Perform daily/nightly execution validation • Carry out verification routines on defined shifts • Work in a rota/on-call schedule when required