Revenue Cycle Collection Specialist

REMOTE:REVENUE CYCLE COLLECTION SPECIALIST

Job Summary:

The Revenue Cycle Collection Specialist is responsible for managing accounts receivable for mental health and substance use disorder services, with a primary focus on resolving unpaid and denied claims. This role ensures timely and accurate reimbursement through claim audits, denial resolution, appeals, and proactive follow-up with payers.

DUTIES, RESPONSIBILITIES, & ESSENTIAL JOB FUNCTIONS - qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:

 Essential Functions:

      Review and resolve outstanding accounts receivable, including payer denials and underpayments

      Perform timely claims follow-up with commercial and government payers

      Identify root causes of denials (e.g., coding, authorization, eligibility) and take corrective action

      Submit corrected claims and draft/submit appeals as needed

      Maintain and work aging AR to reduce outstanding balances

      Review and resolve credit balances

      Verify and update patient demographic, financial, and insurance information

      Ensure accurate documentation of all account activity in billing systems

      Communicate with internal staff, patients, and payers to resolve billing issues

      Evaluate accounts for accurate reimbursement based on payer contracts

      Maintain tracking tools and reporting (Excel, internal systems)

 Non- Essential Functions:

       Participate in performance improvement and quality initiatives

       Maintain confidentiality and compliance with all regulatory requirements

       Represent the organization in a professional manner

       Perform other duties as assigned

      Complete annual education requirements, if applicable

      Maintains standards of professional society procedures and ethical behavior.

      Maintain client confidentiality at all times.

      Report to work on time and as scheduled.

      Participate in performance improvement and continuous quality improvement activities.

      Represent the organization in a positive and professional manner at all times.

      Communicate the mission, ethics and goals of the organization.

Education & Experience:

·       High school diploma or equivalent required

·       Minimum of 2 years of experience in healthcare billing, collections, or related revenue cycle role (behavioral health preferred)

Preferred:

·       Experience with Kipu and CollaborateMD

·       Experience with mental health or substance use disorder billing

·       Strong understanding of UB-04, CMS-1500, EOBs, and payer requirements

·        Knowledge of third-party payer regulations and reimbursement methodologies

·        Ability to analyze denials and determine appropriate next steps

·        Proficient in insurance verification and benefit interpretation

·        Strong attention to detail and documentation skills

·        Excellent communication and organizational skills

·        Ability to prioritize and manage multiple accounts effectively

Physical Requirements and Environmental Conditions:

       Ability to lift up to 25 pounds

       Ability to navigate office environment, including stairs if needed

       Flexibility in scheduling based on operational needs

EEO Statement

All BLR subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. BLR subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.