Senior Revenue Cycle Specialist

Starting Pay Range : $23-$27

After a training period, this position will transition to a hybrid schedule : two days in the office and three days working from home.

Behavioral Health Group (BHG) is the largest network of Joint Commission-accredited treatment centers and a leading provider of opioid addiction treatment services. With over 116 locations in 24 states and a team of more than 1,900 employees, we are dedicated to helping individuals overcome substance use disorders and reclaim their lives. Join us in making a difference.

Job Summary

This position will act as a key member of the Revenue Cycle Department and reports to the Director, Contract and Revenue Cycle. The Revenue Cycle Specialist will help facilitate claims, payments, and verifications daily. The Revenue Cycle Specialist will provide updates and reports on the financial stability of the treatment centers.

Summary of Essential Job Functions

The key responsibilities of the Revenue Cycle Specialist include but not limited to :

Duties and Responsibilities

• Reviews claims data to ensure 3rd party billing requirements are met
• Reviews claims to ensure eligibility, prior authorizations and proper signatures
• Submits claims in an organized sequence in order to achieve reimbursement from private payers, insurance companies and government healthcare programs Medicaid, VA, etc.)
• Investigates denied claims through research and applicable correspondence and follows through to resolution
• Successfully resolves payment discrepancies in a timely manner
• Escalates issues appropriately and promptly to supervision
• Verifies and informs treatment center staff about the patient's financial accountability and 3rd party reimbursement, as applicable
• Posts payments and adjustments while ensuring all deposits are balanced daily
• Documents payment records and issues as they occur
• Completes reporting requirements as required by company policy and requested by supervision
• Demonstrates an understanding of NPI, taxonomy and electronic claim submission requirements
• Identifies underpayments and overpayments / credits to determine steps for resolution
• Retrieves missing payment information from payers through various methods (phone, payer portals, clearing houses, etc.)
• Reads debits and credits on accounts and takes necessary action to resolve
• Performs other duties assigned by supervision

Regulatory

Training

Other

Minimum Requirements

The Revenue Cycle Specialist will be responsible for reviewing claims data to ensure insurance requirements, eligibility, prior authorizations and proper signatures are secured prior to submission. Submits claims in an organized sequence in order to achieve reimbursement from private payers, insurance companies and government healthcare programs with heavy concentration in Medicaid. Will investigate declined claims through research and applicable correspondence in order to successfully resolve payment discrepancies.

Qualifications

The Revenue Cycle Specialist must have the following qualifications.

Physical Requirements and Working Conditions

The physical demands described here are representative of the requirements that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions to the extent such accommodation does not create an undue hardship on the business.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by team members assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of team members so classified. All team members may be required to perform duties outside of their normal responsibilities from time to time, as needed, and this job description may be updated at any time.

BHG is an equal opportunity, affirmative action employer providing equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity / expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law.

Why Join BHG?

Work-Life Balance : Enjoy generous paid time off, holidays, and personal needs. Benefit from flexible schedules with early in / early out hours, no nights, and no Sundays.

Investment in Your Growth : Prioritize your development with role-based training and advancement opportunities.

Comprehensive Benefits : Choose from three benefits programs, including health, life, vision, and dental insurance. Enjoy tuition reimbursement and competitive 401K match.

Recognition and Rewards : Experience competitive pay, quarterly bonuses, and incentives for certifications or licenses.

Employee Perks : Access exclusive discounts on various services and entertainment options, and benefit from our Employee Assistance Program and self-care series.

At BHG, we thrive on the greatness of our people. Join us and become part of a community that values excellence, integrity, and making a real difference in the lives of others.

BHG is an equal opportunity, affirmative action employer providing equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity / expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law.

Starting Pay Range : $22-$26

Equal Opportunity Employer

This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.