Revenue Cycle Specialist

BHG Careers • Brooklyn Park, MN

13h • Hybrid

About The Position

The Revenue Cycle Specialist is a key member of the Revenue Cycle Department and reports to the Director, Contract and Revenue Cycle. This role facilitates daily claims, payments, and verifications, and provides updates and reports on the financial stability of treatment centers. The specialist reviews claim data to verify insurance requirements, eligibility, prior authorizations, and required signatures before submission. Claims are submitted in an organized sequence to support reimbursement from private payers, insurance companies, and government healthcare programs, with a heavy concentration in Medicaid. The specialist also researches declined claims and works to resolve payment discrepancies.

The position is hybrid, with a schedule of 7 a.m. to 3 p.m., Monday through Friday: remote on Mondays and Fridays and onsite Tuesday through Thursday. The starting pay range is $25.00 to $27.00 per hour, depending on experience, with annual bonus potential.

Requirements

• High school diploma or equivalent.
• At least 2 years of revenue cycle management experience, specifically in accounts receivable with government and commercial payers.
• Valid driver’s license.
• High integrity and sound judgment, including when handling confidential and sensitive issues.
• Excellent verbal and written communication skills.
• Strong interpersonal communication and customer service skills.
• Efficient, self-starting approach and ability to work independently under pressure while handling multiple tasks.
• Accurate data entry and basic keyboarding skills.
• Ability to enforce fee collection policies.
• Basic computer and word-processing skills.
• Knowledge and use of typical office equipment and computer programs.
• Knowledge of basic math, accounting, and accounts receivable.
• Ability to communicate effectively by phone or in person and read correspondence and computer screens.
• Ability to sit for prolonged periods and perform some bending, stooping, and stretching; manual dexterity to operate office equipment and tolerate extended keyboarding.
• Ability to work with a variable workload and periodic high stress, including interaction with patients who have varied health and legal issues.

Nice To Haves

• Healthcare experience.
• Experience in front desk, admissions, billing, and/or collections.

Responsibilities

• Review claims data to ensure third-party billing requirements are met.
• Verify eligibility, prior authorizations, and proper signatures before claims are submitted.
• Submit claims in an organized sequence to obtain reimbursement from private payers, insurance companies, and government healthcare programs, including Medicaid and VA.
• Investigate denied claims through research and correspondence, and follow through to resolution.
• Resolve payment discrepancies in a timely manner.
• Escalate issues appropriately and promptly to supervision.
• Verify and inform treatment center staff about patients’ financial accountability and third-party reimbursement, as applicable.
• Post payments and adjustments and ensure deposits are balanced daily.
• Document payment records and issues as they occur.
• Complete reporting requirements specified by company policy or requested by supervision.
• Apply an understanding of NPI, taxonomy, and electronic claim submission requirements.
• Identify underpayments, overpayments, and credits and determine appropriate resolution steps.
• Retrieve missing payment information from payers using methods such as phone calls, payer portals, and clearinghouses.
• Read debits and credits on accounts and take necessary action to resolve them.
• Perform other duties assigned by supervision.
• Comply with federal, state, local, and accrediting-agency requirements.
• Participate in community and public relations activities as assigned.
• Achieve assigned annual goals and objectives.
• Demonstrate respect and care in interactions with patients and team members, maintain positive workplace relationships, and handle confidential matters with sound judgment.
• Participate in and provide required in-service training, and attend conferences, meetings, and training programs as directed.

Benefits

• Generous paid time off, holidays, and personal-needs time.
• Flexible schedules with early-in/early-out hours, no nights, and no Sundays.
• Role-based training and advancement opportunities.
• Choice of three benefits programs, including health, life, vision, and dental insurance.
• Tuition reimbursement.
• Competitive 401(k) match.
• Quarterly bonuses and incentives for certifications or licenses.
• Discounts on services and entertainment.
• Employee Assistance Program and self-care series.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED