Boomerang Healthcare

Therapist

• Provide individual psychotherapy to adult injured workers, including those with accepted psychological claims (PTSD, trauma, anxiety, depression, and chronic pain–related conditions)
• Deliver evidence-based treatment using the full range of modalities for which the clinician is trained and/or certified, including but not limited to CBT, ACT, mindfulness-based interventions, EMDR, and Brainspotting, applying the modality clinically indicated for each patient’s presentation
• Conduct initial psychological assessments and develop, document, and update individualized treatment plans
• Facilitate group therapy (e.g., weekly coping skills group) as assigned
• Complete all clinical documentation in the EMR within 24–48 hours of each encounter, in accordance with workers’ compensation and payer requirements
• Actively coordinate care with the pain management team, including timely participation in case conferences, internal messaging, and referrals across clinic modalities
• Respond to internal communications (EMR messages, email, secure chat) within one business day
• Participate in clinical supervision, peer consultation, quality assurance, and chart review as directed
• Manage de-escalation of patients experiencing mental health crises or acute psychiatric episodes in a virtual setting; assess suicidal ideation and safety risk; and initiate appropriate interventions including safety planning and referrals in accordance with organizational SOP and clinical standards
• Attend required team meetings, including the Monthly Mental Health Meeting and any additional staff or training meetings called by leadership
• Maintain compliance with all legal, ethical, licensure, HIPAA, and workers’ compensation standards
• Follow clinical and administrative direction from the Director of Behavioral Health
• Perform other clinical and administrative duties as assigned that are reasonably related to the role of Licensed Clinical Therapist.

Licensed Clinical Therapist, LCSW, LMFT, LPCC

IT Support

• Manage the help desk ticketing system
• Inventory control and management
• Shipping and packing
• Answer emergency help-desk phone line
• Assist with Tier 1 ticket resolution
• Assist IT team in projects and daily operations as needed
• Respond to technical requests by phone, email, or ticketing system as needed to maintain SLAs and Help Desk coverage
• Track statistics on issue and problem resolutions
• Work with systems and network teams to resolve customer issues
• Answer help desk phone line and triage issues as needed
• Ensure duties are delegated properly and tasks are complete on time
• Asset management, shipping and tracking

IT Helpdesk Technician

Auditor

• Audit execution & oversight by performing routine and ad hoc audits across the full revenue cycle process, including: Charge entry and charge capture accuracy, CPT, HCPCS, and ICD-10 coding compliance, Modifier usage, Workers’ compensation billing rules and state-specific fee schedules, Claim submission accuracy and clean claim rates, Payment posting and adjustment accuracy, AR follow-up effectiveness and denial resolution workflows
• Conduct pre-bill and post-bill audits to identify trends impacting reimbursement and compliance
• Denial & Revenue leakage analysis: Analyze denial trends across WC, Medicare, and commercial payers, Identify root causes of denials and recommend corrective actions, Quantify revenue impact from: Coding errors, Missed charges, Underpayments, Inefficient workflows
• Ensure adherence to: CMS guidelines and Medicare billing requirements, NCCI (CCI edits) and payer-specific edits, State Workers’ Compensation regulations, Documentation standards for pain management procedures
• Support internal and external audit readiness (RAC, MAC, payer audits).
• Reporting & KPI development through audit dashboard Maintain monthly & quarterly records of all RCM, clinical, and provider audit scores and training requirements
• Partner with all BHC teams to develop and deliver targeted education based on audit findings.
• Assist in creating and updating SOPs and workflows to reduce errors and improve efficiency
• Establish and maintain quality assurance programs across RCM functions
• Perform routine QA reviews of staff productivity and accuracy
• Recommend automation opportunities and system enhancements
• Assumes other responsibilities as appropriate to the position and organizational needs

RCM Auditor

Claims Specialist

• Investigate and resolve claim rejections, denials, and payer edits identified before or after claim submission
• Review claim history, payer correspondence, medical records, authorizations, and supporting documentation to determine the cause of claim issues
• Correct billing, coding, demographic, authorization, and insurance-related claim errors as appropriate
• Process claim corrections, adjustments, resubmissions, and reconsideration requests in accordance with payer guidelines
• Perform payer research and communicate directly with insurance carriers to resolve claim processing issues
• Monitor assigned work queues and ensure timely resolution of outstanding claims
• Escalate complex reimbursement, coding, or compliance issues to senior team members
• Partner with A/R and Denials Management teams to resolve denied and underpaid claims
• Assist in preparing appeal documentation and supporting materials for denied claims
• Identify recurring denial patterns and communicate findings to the Senior Claims Resolution Coordinator
• Maintain accurate documentation of denial resolution activities and payer communications
• Support efforts to reduce preventable denials and improve reimbursement outcomes
• Work closely with the pre-billing team to identify and correct claim issues prior to submission
• Review claims for completeness and compliance with payer billing requirements
• Verify insurance information, authorizations, referrals, diagnosis coding, procedure coding, and modifier usage
• Collaborate with coding and clinical teams to obtain information needed for claim resolution
• Assist with reducing claim holds and billing delays
• Participate in routine claim quality reviews and internal audit activities
• Ensure claim corrections comply with payer regulations, organizational policies, and billing guidelines
• Support Revenue Integrity initiatives through accurate claim review and documentation
• Maintain knowledge of Medicare, Medicaid, Workers' Compensation, and Commercial payer requirements
• Adhere to HIPAA, CMS, and organizational compliance standards
• Maintain detailed documentation of claim investigations, resolutions, payer communications, and follow-up activities
• Track assigned workloads and resolution outcomes
• Assist with compiling information for denial trend reporting and operational reviews
• Provide feedback regarding workflow issues contributing to claim errors or payment delays
• Assumes other responsibilities as appropriate to the position and organizational needs

Claims Resolution Specialist

Events

• Direct and manage AR follow-up activities across all payer types, including: Workers’ Compensation (fee schedules, direct bill, employer/carrier models), Commercial insurance, Medicare.
• Establish AR prioritization strategies by payer, aging bucket, service line, and dollar value.
• Monitor and drive performance for current AR, 31-60, 61-90, 91-180, and 181+ day buckets.
• Manage the resolution of holds, missing information, and errors related to claim submission.
• Partner with finance to support monthly AR reconciliation, variance analysis, and cash forecasting.
• Provide direct oversight of WC AR and staff.
• Manage litigation-related AR.
• Oversee lien preparation, submission, tracking, and resolution.
• Lead denial prevention strategies across all payers.
• Oversee denial management workflows.
• Manage appeals and reconsiderations for: Medicare, Commercial payers, Workers’ Compensation disputes.
• Assumes other responsibilities as appropriate to the position and organizational needs.

AR & Denial Prevention Manager

Billing Specialist

• Oversee all billing operations for Pain Management Practice
• Ensure accurate, compliant, and timely billing for clinic visits, interventional procedures, injections, diagnostics, and rehabilitation services
• Drive clean claim submission and optimal cash flow
• Manage billing for clinic visits, interventional pain procedures, injections, diagnostics, and rehabilitation services
• Ensure accurate charge entry, claim creation, and timely submission
• Serve as subject matter expert for pain management billing, fees schedules, liens, and direct bill processes
• Supervise billing staff, set productivity standards, and conduct performance reviews
• Partner with coding, authorization, AR, and clinical teams to resolve claim issues
• Monitor billing KPIs including clean claim rate, billing lag, and rejection trends
• Conduct audits and implement corrective action plans as needed

Licensed Clinical Therapist, LCSW, LMFT, LPCC

IT Helpdesk Technician

RCM Auditor

Claims Resolution Specialist

AR & Denial Prevention Manager

Billing Manager