Senior Revenue Cycle Specialist

Position Summary:

The ideal candidate is detail-oriented, proactive, and capable of working independently in a fast paced environment. They should be comfortable navigating complex billing rules and identifying process improvements.

Key Responsibilities:

• Manage end-to-end revenue cycle processes for behavioral health services (Outpatient & IOP).
• Perform AR follow-up on denied, underpaid, and outstanding claims (primary focus of role).
• Post daily ERAs (Electronic Remittance Advice) and handle $0 payment follow-ups.
• Conduct Verification of Benefits (VOB) and ensure accuracy of insurance coverage.
• Review and reconcile patient payments and financial responsibility.
• Troubleshoot claim errors, denials, and contract discrepancies.
• Identify and track payer trends and recurring billing issues.
• Submit and follow up on medical records requests.
• Handle appeals as needed.
• Prioritize and manage assigned accounts independently to ensure timely resolution.
• Ensure compliance with payer-specific rules, including supervision and billing guidelines.

Required Qualifications:

• Strong knowledge of revenue cycle management.
• Experience with both facility and professional billing.
• Proven experience in AR follow-up, claim denials, and resolution.
• Familiarity with:

o Payer portals

o Insurance verification (VOB)

• Ability to work across multiple billing types, including Outpatient and IOP services.
• Experience with Nevada payers and regulations is highly preferred.
• Proficiency in Microsoft Excel (data tracking, reporting, analysis).

Preferred Skills & Traits:

• Strong analytical and problem-solving skills.
• Fast learner with the ability to adapt quickly in a dynamic environment.
• Excellent time management and ability to prioritize tasks independently.
• Ability to identify inefficiencies and propose process improvements.
• Sharp attention to detail with a proactive mindset.
• Comfortable working without rigid templates or protocols