Revenue Cycle Collections Specialist

Behavioral Innovations • Plano, TX

1d • Onsite

About The Position

The Revenue Cycle Collections Specialist ensures accurate and timely adjudication of third-party claims submitted to insurance carriers. The role supports increased cash collections and reduced aging in third-party accounts receivable by following up on outstanding claims and patient account balances. Work includes addressing denials and zero payments, submitting corrected or secondary claims, providing medical records, locating missing payments, initiating appeals, correcting posting errors, processing adjustments and write-offs, resolving credit balances, using payer and clearinghouse portals, and managing payer correspondence. The Specialist researches issues and applies payer guidelines, company policies, and third-party collection best practices while communicating with Commercial, Medicaid, and Managed Care payers and internal RCM leadership.

The position is based onsite at the company’s corporate office in Addison, Texas. A hybrid schedule may become available based on individual performance. Behavioral Innovations provides center-based ABA therapy for children with autism and describes its work as mission- and values-driven.

Requirements

• At least five years of experience in the healthcare industry.
• At least five years of experience in medical revenue cycle collections.
• Strong attention to detail and commitment to high-quality work.
• Excellent judgment and decision-making skills.
• Clear and effective communication abilities.
• Proactive approach to identifying and resolving issues.
• Eagerness to learn and take on new responsibilities.
• Demonstrated resourcefulness, collaboration, and teamwork.
• Consistently uphold and reflect Behavioral Innovations’ core values in professional interactions.
• Must currently reside in the Dallas–Fort Worth area; the role requires onsite work at the corporate office in Addison, Texas.

Nice To Haves

• At least five years of experience in a behavioral health or medical clinic setting; preferred but not required.

Responsibilities

• Analyze claim payments using internal systems and tools to ensure provider reimbursement aligns with applicable state fee schedules.
• Review payer documentation and contact insurance carriers by phone to confirm claim receipt and facilitate reimbursement.
• Investigate and resolve third-party payer claim issues, including initiating claim adjustments and resubmissions according to payer-specific guidelines.
• Follow up on submitted claims to ensure timely payment and escalate unresolved issues to payers, internal departments, or RCM leadership as needed.
• Evaluate payment and denial accuracy, apply payments to patient accounts, and identify bad-debt write-offs and accounts receivable adjustments according to company policy.
• Detect and resolve duplicate or overpayments and process necessary corrections.
• Communicate with internal departments to obtain missing patient or insurance information.
• Comply with HIPAA regulations and applicable federal, state, and payer guidelines.
• Verify billing accounts against the accounts receivable ledger to confirm accurate payment posting.
• Document interactions in the EHR, including call details, contact information, and outcomes.
• Address denial issues within three days of receipt.
• Submit medical records and other required documentation for medical-necessity reviews, denials, and appeals in a timely manner.
• Submit secondary claims promptly after receipt of the primary remit.
• Work to reduce third-party accounts receivable and improve days sales outstanding.
• Use electronic medical records and billing systems efficiently.
• Collaborate with team members, leadership, and other departments using strong interpersonal and communication skills.
• Support workflows across departments and perform other duties as assigned.

Benefits

• Medical, vision, dental, and supplemental insurance policies.
• Wellbeing program with tools to support wellness goals.
• Employee Assistance Program (EAP) supporting mental, emotional, and physical health.
• Hourly pay.
• Hybrid schedule eligibility based on individual performance.

What This Job Offers

• Job Type: Full-time
• Education Level: No Education Listed