What are the responsibilities and job description for the Billing & Revenue Cycle Specialist position at Riverview Center for Growth?
Join Our Team at Riverview Center for Growth!Billing & Revenue Cycle Specialist
Riverview Center for Growth is seeking a detail-oriented and experienced Billing & Revenue Cycle Specialist to join our Finance / Administration team. This position is responsible for managing the full revenue cycle, including claims submission, payment posting, accounts receivable, denials and appeals, payer follow-up, and billing reconciliation.
The ideal candidate will have strong experience with Oregon Health Plan (OHP)/Medicaid and behavioral-health billing, excellent attention to detail, strong analytical and problem-solving skills, and the ability to independently manage multiple billing priorities and deadlines.
What You’ll Do
- Manage the full revenue cycle, including insurance eligibility, authorizations, claims submission, payment posting, reconciliation, denials, appeals, and collections.
- Submit and monitor claims for OHP/Medicaid, CCOs, commercial insurance, and other payers, ensuring accurate coding, documentation, and timely filing.
- Review and resolve claim rejections, denials, underpayments, and other billing discrepancies.
- Monitor and manage accounts receivable, following up with payers and prioritizing outstanding claims and balances.
- Apply knowledge of Oregon Medicaid/OHP and behavioral-health billing requirements, including CPT/HCPCS codes, modifiers, authorizations, and payer-specific rules.
- Review billing and service documentation to identify missing information, unbilled services, coding issues, and potential revenue loss.
- Maintain accurate billing records and reports, assist with audits and compliance, and protect confidential client and financial information.
- Work collaboratively with Finance, clinical, program, and administrative staff to resolve billing issues and improve revenue-cycle processes.
- Monitor billing trends and performance indicators and identify opportunities to reduce denials, improve collections, and increase billing efficiency.
What We’re Looking For
Required Qualifications:
- Minimum of 3 years of medical and/or behavioral-health billing experience, including significant hands-on experience with Medicaid/OHP.
- Demonstrated experience managing the full revenue cycle, not solely claim submission.
- Working knowledge of:
- Oregon Medicaid/OHP
- CCO billing
- Commercial insurance
- Behavioral-health billing
- CPT/HCPCS coding and modifiers
- Authorizations
- Claims submission
- EOBs/ERAs
- Denials and appeals
- Accounts receivable management
- Payment posting
- Claim reconciliation
- Experience working with an electronic health record and/or medical billing system.
- Strong computer skills, including Microsoft Excel.
- Excellent attention to detail and accuracy.
- Ability to independently research payer requirements and resolve complex billing issues.
- Ability to maintain confidentiality and appropriately handle sensitive client and financial information.
Preferred Qualifications:
- Certified Billing Specialist certification or comparable recognized medical billing/revenue-cycle certification.
- Experience working in an Oregon community behavioral-health organization.
- Experience with OHA, CCO, Medicaid, and behavioral-health fee schedules.
- Experience with youth behavioral-health services.
- Experience working in a nonprofit or publicly funded healthcare program.
- Experience with billing audits and compliance reviews.
- Experience developing billing procedures or improving revenue-cycle workflows.
- Advanced Excel and reporting skills.
- Experience with Riverview’s electronic health record and billing platforms, or similar systems.
The Ideal Candidate Will Have
- Strong understanding of the complete healthcare revenue cycle.
- Advanced knowledge of Medicaid/OHP billing.
- Strong analytical and problem-solving skills.
- Excellent attention to detail.
- Ability to identify patterns in denials and reimbursement problems.
- Strong organizational and time-management skills.
- Ability to manage multiple priorities and deadlines.
- Strong written and verbal communication skills.
- Ability to work independently with minimal supervision.
- Professional judgment and discretion when handling confidential information.
- Ability to establish effective working relationships with clinical, administrative, financial, and external payer partners.
Compensation
$27.00–$33.00 per hour ($28,080–$34,320 annually based on a 20-hour workweek).
Placement within the salary range will be determined based on education, certification, years of relevant experience, demonstrated Medicaid/OHP expertise, behavioral-health billing experience, and demonstrated ability to independently manage the full revenue cycle.
Equal Employment Opportunity
Riverview Center for Growth is committed to providing equal employment opportunities and maintaining a workplace free from unlawful discrimination and harassment. Employment decisions are based on qualifications, business needs, and organizational requirements in accordance with applicable federal, state, and local law.
Pay: $27.00 - $33.00 per hour
Expected hours: 20.0 per week
Work Location: In person
Salary : $28,080 - $34,320