Revenue Cycle Specialist
About The Position
Research and follow up on billing and payment Denials, Helds and other irregularities in a Behavioral Health Setting. Includes all activities within the scope of the Billing & Accounting Departments including charge/ data entry, insurance follow up, and billing and collection of client balances. Adheres to Billing and Accounting regulations, company policy, HIPPA, 42CFR, CMS, DHCS, DPH/SAPC, DMH guidelines and statutes and contract requirements. Assist in identifying, analyzing and addressing challenges and / or breakdowns in the revenue cycle process. Perform ongoing trend analysis of payer rejections and denials. Assist in performing proactive audits on all recommended A/R write offs. Collaborate closely with other departments to contribute to cash reconciliation activities and to assist in the assessment of accounts receivable collectability and validation, including the writing off of bad debts. Assist with the review of contracted rates and reimbursements. Assist in the creation and development of reports to address management needs; analyze information to identify trends or issues. Work in multiple EHR systems.
Requirements
- Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field. Equivalent experience may be considered in lieu of a degree.
- Minimum of 3 years of experience in revenue cycle management within a healthcare setting, preferably in behavioral health services.
- Proven track record in managing billing, collections, and accounts receivable processes.
- Experience with healthcare insurance claims processing and knowledge of payer requirements.
- Familiarity with electronic health records (EHR) systems and healthcare billing software.
- Strong analytical skills with the ability to interpret financial data and generate actionable insights.
- Excellent communication skills, both written and verbal, with the ability to interact effectively with internal teams and external stakeholders.
- Detail-oriented with strong organizational skills to manage multiple tasks and priorities efficiently.
- Proficiency in Microsoft Office Suite, particularly Excel, for data analysis and reporting.
- Ability to work independently as well as collaboratively in a team-oriented environment.
- Knowledge of healthcare regulations and compliance standards, including HIPAA.
- Problem-solving skills with a proactive approach to identifying and resolving issues in the revenue cycle process.
Responsibilities
- Ongoing process improvement analysis and implementation of system improvements.
- Insurance follow up, and billing and collection of client balances.
- Adherence to Billing and Accounting regulations, company policy, HIPPA, 42CFR, CMS, DHCS, DPH/SAPC, DMH guidelines and statutes and contract requirements.
- Identifying, analyzing and addressing challenges and / or breakdowns in the revenue cycle process.
- Performing ongoing trend analysis of payer rejections and denials.
- Performing proactive audits on all recommended A/R write offs.
- Collaborating closely with other departments to contribute to cash reconciliation activities and to assist in the assessment of accounts receivable collectability and validation, including the writing off of bad debts.
- Review of contracted rates and reimbursements.
- Creation and development of reports to address management needs; analyze information to identify trends or issues.
- Work in multiple EHR systems.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
