RCM Specialist

Charlie Health•Nashville, TN

1d•Hybrid

About The Position

This role is responsible for driving the foundational stages of the reimbursement cycle by managing initial and mid-stay authorizations, payor notifications, and daily billing system triaging. Securing timely authorizations and maintaining precise documentation is a critical step in the financial process, directly preventing coverage gaps and administrative denials. By proactively managing these worklogs, this specialist ensures steady revenue flow, minimizes financial risk during a client's treatment stay, and protects the organization’s ability to get reimbursed for services. Our team is composed of passionate, forward-thinking professionals eager to take on the challenge of the mental health crisis and play a formative role in providing life-saving solutions. We are looking for a candidate who is inspired by our mission and excited by the opportunity to build a business that will impact millions of lives in a profound way.

Requirements

2–3 years of related work experience in healthcare administrative roles, specialized billing, prior authorizations, insurance verification, or claims management
Strong knowledge of prior authorization processes, payor portals, and medical medical billing practices
Proficiency with RCM billing systems and workflow triaging to effectively navigate and manage daily electronic task queues
Knowledge of all confidentiality requirements (HIPAA) regarding patients and strict maintenance of proper confidentiality on all such information
Excellent written and verbal communication skills for professional and persistent correspondence with insurance payors
Strict attention to detail to ensure complex authorization timelines, dates of service, and policy numbers are accurately recorded
Strong organizational and time-management skills to balance multiple mid-stay policy changes and time-sensitive payor notifications simultaneously
Able to work a hybrid schedule of 4 days/week in our Nashville office and located within 75 minutes' commuting distance of the office

Responsibilities

Submitting initial authorization requests and tracking progress through final payor outcome to ensure coverage is active prior to service delivery.
Managing and submitting new policy authorization requests for active clients who experience a change in coverage mid-treatment stay.
Issuing timely notifications of non-admission to specific payors to remain compliant with strict contractual notice requirements.
Triaging and prioritizing daily worklog tasks within the RCM billing system to resolve bottlenecks and keep claims moving forward.
Executing ad hoc authorization and billing tasks as directed by management to support general department workflows and revenue capture.