RCM Specialist

About Us:

Forge Health is a mission-driven outpatient mental health and substance use provider dedicated to providing the highest quality, affordable, and effective care to individuals, families, and communities in need. As the first and only behavioral healthcare provider with a proven, national payer-validated ability to drive clinical outcomes that span all areas of health, Forge Health is leading the charge in driving innovation, improving care delivery, and shaping the future of behavioral health care.

At Forge, clinical care is paramount – it's the heartbeat of our operations and the driving force in everything we do. The skill and compassion of our staff are the crucial components to extraordinary experiences and outcomes for those we serve. With our current clinical footprint in the greater Northeast, we have offices in New York, New Jersey, Pennsylvania, New Hampshire – and we're growing! Come join us!

Who we're looking for:

The RCM Specialist will coordinate billing and collection operations, ensuring timely billing of insurance companies for all billable procedures, pursuing collections until payment is received, and performing other billing-related tasks such as payment posting and denial management. This position can be performed remotely.

Compensation range: $45-55k. This salary range reflects total compensation, which includes base compensation, but does not include benefits and other company perks. Exact compensation may vary based on skills, experience, and location.

What you'll be doing:

• Obtain, track, and update pre-certifications and authorizations per insurance carriers.
• Prepare and submit clean claims electronically to various insurance carriers.
• Monitor and correct clearinghouse and payer claims rejections.
• Follow-up and resolve outstanding receivables utilizing remittance reports and/or explanation of benefits (EOBs).
• Identify and resolve insurance claim denials and submit appeals.
• Ensure patient statements are sent accurately and promptly.
• Post insurance and patient payments based on daily deposits received.
• Ensure strict confidentiality of personal client information and data.
• Draft and edit documents/communications, as needed.
• Assist clinical staff in providing excellent customer service to all clients.
• Perform any other duties as required by manager.
  
  

How we define success:

• 3 years of billing and collections experience.
• Preferred 2 years of specific experience within the healthcare sector, especially mental health and behavioral health claims.
• Bachelor's degree required.
• Certified Professional Coder preferred.
• Detail-oriented with excellent analytical, problem-solving, and organizational skills.
• Ability to keep confidential medical records of patients.
• Works well in groups as well as individually, with minimal supervision.
• Flexible, adaptive, punctual, and highly reliable.
  
  

Why Forge?

The opportunity:

Our team refuses to compromise on integrity, and we look for talented, driven hard workers who hold the same passion for the pursuit of high quality, evidence-based mental health and substance use care that we do. Our collective passion is driven and embodied by our core values:

• Fulfilling: Our work creates lives that are complete and self-actualized, enabling stronger families and communities – and a therapeutic community rewarded by success
• Optimistic: Our passionate positivity and empathy overcome setbacks and get you to your goals, scientifically and humanely
• Reciprocal: Without mutual trust and commitment, there can be no progress
• Grateful: We profoundly recognize and appreciate the trust of our patients and the commitment of our clinicians
• Evidence-Based: We are committed to measurable outcomes, which provide confidence to our patients and creates a standard of care for ourselves and others
  
  

The package:

At Forge, our people are our greatest asset. We're collaborative, empathetic, and passionate. We learn from our mistakes, we carve out time to breathe, and we are celebrated for our wins. In short, we know that we can't do what we do without you! So, we designed a comprehensive, competitive benefits package that reflects our appreciation of our people:

• Competitive salary aligned with your experience
• Comprehensive paid time off package
• Annual time off to volunteer
• Parental leave
• Annual continuing education allocations
• Competitive medical, dental, and vision package
• Annual subscription to a leading meditation app
• An environment that fosters professional development including financing for advanced licensure and certifications
• Internal supervision opportunities
• Dedicated, motivated team and chance to be part of a highly ambitious medical startup
• Modern, elegant, and high-end work environment
  
  

We are committed to equal employment opportunity. We give equal consideration to all applicants when filling positions without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, age, actual or perceived disability, genetic information, marital status, and/or any other status not related to an applicant's ability to perform the job duties. All employment practices will be carried out in accordance with federal, state and local laws.

We will also fully comply with regulations and requirements set out by the Americans with Disabilities Act (ADA) and the ADA amendments Act (ADAAA). We will not discriminate against applicants or other individuals with real or perceived disabilities. When needed, we will provide reasonable accommodation to otherwise qualified candidates so that they are able to perform the essential functions of the position.