Revenue Cycle Specialist (Remote)

Changing Lives at Home Mental Health Inc.•Baltimore, MD

3d•Remote

About The Position

Changing Lives at Home (CLH) is a leading behavioral health organization dedicated to providing comprehensive behavioral health services. Our extraordinary team supports individuals through our five core programs, including Psychiatric Rehabilitation Program (PRP), Outpatient Mental Health Clinic (OMHC), Substance Use Disorder (SUD), Health Home, and Group Home services, ensuring compassionate, person-centered care while maintaining the highest standards of quality, compliance, and support for the communities we serve. We are seeking a detail-oriented Revenue Cycle Specialist to support CLH's billing and reimbursement operations. This remote position is responsible for ensuring accurate claims processing, payment reconciliation, and accounts receivable management while maintaining compliance with payer requirements and agency policies.

Requirements

Bachelor's Degree required.
Minimum of 2–5 years of experience in revenue cycle management, medical billing, payment reconciliation, or a related healthcare billing role.
Experience with Mental Health Billing, including OMHC, PRP, and SUD, is required.
Strong knowledge of medical billing, claims processing, payment reconciliation, accounts receivable, and reimbursement practices.
Experience working with Electronic Health Record (EHR) systems and medical billing software.
Knowledge of HIPAA, healthcare regulations, Joint Commission standards, and payer requirements.

Nice To Haves

Relevant certifications in medical billing or revenue cycle management are an advantage but not required.

Responsibilities

Manage and coordinate revenue cycle activities to support accurate and timely reimbursement from multiple insurance payers.
Reconcile insurance payments by reviewing Electronic Remittance Advice (ERA), Explanation of Benefits (EOB), and payment records to ensure accurate payment posting and identify payment discrepancies.
Monitor claim status, resolve reimbursement issues, and support accounts receivable activities.
Verify consumer insurance eligibility, benefits, coverage, and prior authorizations.
Maintain authorization records within the agency's electronic systems.
Prepare payment reconciliation and revenue cycle reports.
Collaborate with insurance payers, the billing team, providers, clinical staff, and leadership to support efficient and compliant revenue cycle operations.
Provide administrative support to the Executive Director.
Ensure compliance with payer requirements, the Health Insurance Portability and Accountability Act (HIPAA), The Joint Commission standards, and agency policies.
Verify consumer insurance eligibility, benefits, coverage, and prior authorizations.
Review claim information for accuracy and coordinate with the billing team responsible for claim submission.
Monitor claim status and follow up on denials, rejections, payment corrections, and outstanding reimbursements.
Communicate with insurance payers regarding claims, appeals, and reimbursement issues.
Reconcile insurance payments using Electronic Remittance Advice (ERA), Explanation of Benefits (EOB) documents, and payment records.
Investigate and resolve payment discrepancies, underpayments, and overpayments.
Post and reconcile insurance and patient payments.
Monitor accounts receivable and maintain accurate billing and reconciliation records.
Analyze billing records and supporting documentation for accuracy and compliance.
Maintain authorization records and prepare revenue cycle and reconciliation reports.
Ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA), payer requirements, The Joint Commission standards, and agency policies.
Collaborate with insurance payers, the billing team, providers, and clinical staff to resolve billing and reimbursement issues.
Provide administrative support to the Executive Director.
Perform other duties as assigned.