Billing Specialist

About TouchCare TouchCare is redefining how employees experience healthcare. As a leading healthcare advocacy and navigation company, we combine innovative technology with personalized, white-glove support to help members confidently navigate every aspect of their healthcare journey. Whether finding the right provider, understanding benefits, resolving claims, or managing complex healthcare needs, our team is there every step of the way. Headquartered in Stamford, Connecticut, with offices in Shrewsbury, New Jersey, TouchCare partners with employers nationwide to deliver a concierge healthcare benefit that simplifies healthcare, improves the employee experience, and drives better outcomes through expert guidance and compassionate service. About the Role TouchCare is seeking a knowledgeable, detail-oriented Billing Specialist who is passionate about solving complex healthcare billing challenges and advocating for members. As part of our Member Services team, you'll investigate and resolve medical, dental, vision, and behavioral health billing and insurance claims issues. You'll work directly with members, healthcare providers, and insurance carriers to identify errors, clarify coverage, and help reduce unnecessary out-of-pocket costs. This role combines analytical problem-solving, insurance expertise, and compassionate service. You'll navigate complex claims, interpret plan benefits, and advocate for fair, accurate billing outcomes. This is more than processing claims. It's about helping people understand their healthcare costs, resolve frustrating billing issues, and feel confident navigating the healthcare system. What You'll Do Billing & Claims Resolution: Investigate and resolve complex medical, dental, vision, and behavioral health billing issues, including denied, incorrectly processed, or disputed claims. Member Advocacy: Serve as a trusted resource, helping members understand insurance coverage, Explanation of Benefits (EOBs), claims decisions, and financial responsibilities. Claims Investigation: Review billing records, plan documents, benefit interpretations, and claims adjudication guidelines to identify errors and coordinate corrections or resubmissions. Carrier & Provider Coordination: Work directly with insurance carriers, healthcare providers, and billing departments to resolve discrepancies and pursue appropriate outcomes. Benefits Expertise: Navigate commercial health plans and related benefits, including FSA, HRA, and HSA accounts. Case Management: Manage multiple cases and deadlines while maintaining accurate documentation and proactive member communication. Team Collaboration: Support fellow Billing Specialists and Healthcare Assistants with complex cases, escalations, and claims-related questions. Process Improvement: Identify recurring payer and provider issues, communicate trends to leadership, and recommend opportunities to improve resolution processes. What You Bring We're looking for someone who enjoys investigating problems, understands health insurance, and genuinely wants to make healthcare easier for others. 3–5 years of experience in medical billing, insurance claims, claims management, or healthcare revenue cycle operations. Bachelor's degree or equivalent relevant experience. Strong understanding of health insurance benefits, claims processing, billing practices, and reimbursement. Experience interpreting EOBs, plan documents, and claims adjudication guidelines. Medical office, provider billing, or insurance carrier experience preferred. Excellent research, analytical, and problem-solving skills. Strong written and verbal communication skills with a service-first approach. Exceptional organization, attention to detail, and ability to manage competing priorities. Proficiency in Microsoft Office and comfort navigating multiple systems. Ability to work independently, collaborate across teams, and escalate complex issues appropriately. You'll Thrive Here If You Are... Inquisitive: You love investigating complex issues and finding answers. Compassionate: You understand that behind every claim is a person who needs help. Detail-Oriented: You catch discrepancies others might miss. Resourceful: You know how to navigate challenges and advocate for solutions. Persistent: You follow through until issues are resolved. Collaborative: You enjoy sharing knowledge and supporting your teammates. Accountable: You take ownership of your cases and de