Behavioral Health RCM Solutions, LLC

Compensation

Full Description

Behavioral Health Revenue Cycle Management Solutions, LLC Job Title: Level 1 RC Specialist Job Location: This is a remote job. General Description of the Job The claims specialist position provides comprehensive support for BHRCMS’s professional behavioral health revenue cycle operations. Main responsibilities include analyzing, trending, and working denials. Other responsibilities may include: • Obtaining and verifying authorizations • Verify and update eligibility • Cash application and direct data entry of claims into payer portals for Behavioral Health Clients, the majority of which are in Massachusetts. • Review and analyze trends, advising BHRCMS’s leadership regarding conclusions and recommendations. • Serve as an expert resource for covered areas. Duties and Responsibilities of this Level Professional Behavioral Health Insurance Denials: The Level 1 Revenue Cycle Claims Specialist investigates, resolves, and responds to a multitude of professional behavioral health insurance denials, which involves research, analysis, and problem-solving to prevent denials from occurring in the future. Eligibility and Authorizations: The Level 1 Revenue Cycle Claims Specialist will assist in performing client eligibility verification and obtaining authorizations from insurance companies and entering the authorization information into the Electronic Health Record systems. Behavioral Health Claims: The Level 1 Revenue Cycle Claims Specialist must investigate and resolve all claims made under the client’s behavioral health coverage. This requires the ability to review electronic explanations of benefits from the insurance company, post the contractual obligation, the patient liability, and payment received, when applicable to the patient’s account. The specialist should have an understanding of Remittance Advice Remark Code and the steps to take to resolve. The specialist should have the skills to re-work claims, write multi-level appeals, and speak directly with the payers when needed. Ability to discover claim trends and communicate findings. Perform other related duties incidental to the work described herein. Supervisory Responsibility: No Required Qualifications at this Level Education: High School diploma or GED is required Experience: A minimum of three years of billing/collection in healthcare is preferred. Previous experience successfully managing complex projects involving multiple stakeholders, with a consistent track record of delivering on time and/or high-quality results preferred. Knowledge, Skills, and Abilities: • Massachusetts Behavioral Health billing knowledge preferred • CareLogic and/or myEvolv EHR proficient preferred • Denial management experience required • Eligibility experience preferred • Authorization experience preferred • Microsoft Office – Proficient - (Excel, Word) required • Excellent communication skills (verbal and written) are essential • Detail-oriented, systematic, and innovative • Strong analytical and problem-solving skills • Must be able to meet deadlines, work independently, set priorities, and maintain confidentiality • Ability to work calmly and efficiently in high-pressure situations The intent of this job description is to provide a representative a level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform related tasks other than those specifically presented in this description. Behavioral Health Revenue Cycle Management Solutions, LLC is an Affirmative Action/Equal Opportunity BHRCMS is committed to providing employment and consulting opportunities without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status. Behavioral Health Revenue Cycle Management Solutions, LLC is an at-will employer. Job Types: Full-time, Contract Pay: $17.00 - $19.00 per hour Benefits: • Dental insurance • Health insurance • Life insurance • Paid time off • Vision insurance Work Location: Remote