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
Professional Requirements:
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.
Qualifications:
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
Competencies - Knowledge, Skills, and Abilities:
· 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.
