Revenue Cycle Specialist

Job Summary:

Research and follow up on billing and payment Denials, Helds and other irregularities in a Behavioral Health Setting

Duties/Responsibilities:

• Ongoing process improvement analysis: and implementation of system improvements. 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