Revenue Cycle Specialist

Mental Health Services For Clark & Madison Counties

Job Location:

London, KY - USA

Monthly Salary: Not Disclosed

Posted on: 30+ days ago

Vacancies: 1 Vacancy

Job Summary

REVENUE CYCLE SPECIALIST

FT 40 hours per week

Monday-Friday

The Revenue Cycle Specialist supports claims timely cash posting and denial prevention/resolution across outpatient community-based telehealth and (if applicable) inpatient psychiatry services. This role blends day-to-day billing work (eligibility charge review claim edits payment posting denials/appeals) with data-minded tasks (work queue monitoring payer trend analysis). The Specialist partners closely with clinical administrative utilization review and IT/HER teams to protect revenue and ensure compliance with HIPAA and 42 CFR Part 2.

Responsibilities

Patient Access & Financial Clearance

Perform financial registration for new outpatient and inpatient ensuring accurate entry of information including documentation for contracted mental health boards.

Update financial records for existing patients as necessary.

Verify eligibility/benefits document member cost-sharing and flag coordination-of-benefits issues.

Track prior authorizations (initial/concurrent) and escalate risks to clinical leaders.

Billing Claims & Edits

Prepare and submit timely compliant claims; resolve clearinghouse rejections and payer edit work queues.

Manage secondary/tertiary billing; meet timely filing limits per payer contracts.

Cash Posting & A/R Follow-Up

Post remittances reconcile unapplied cash resolve credit balances/refunds and support month-end close.

Work A/R follow-up queues by aging balance and denial category; document all touches thoroughly.

Denials Management & Appeals

Classify denials (eligibility authorization coding medical necessity COB late filing frequency) and complete accurate timely appeals.

Other Responsibilities

Support Revenue Integrity Analyst in credentialing for all clinical staff and organizational facilities

Support front desk staff with coverage gaps

Treats patients and family with dignity and respect and holds all patient information in the strictest confidence.

Adhere to professional standards policies and procedures federal state and local requirements and Joint Commission standards including National Patient Safety Goals. Presents a positive image of MHSCC to other community agencies caregivers and citizens

Completes all MHS required education and training including initial agency orientation mandatory training and education and upkeep of all required certifications and licensures as required by state federal and regulatory requirements.

Demonstrates organizational stewardship and exemplifies the mission vision and values of MHS.

Performs other job-related tasks as assigned

Education/Experience

High School Diploma or equivalent

Associates degree in accounting business or related field preferred

1-3 years experience with medical billing preferred

Experience with Joint Commission federal and state (Ohio) regulations and standards (preferred)

MHS provides CPR/First Aid and NVCI (CPI Blue) for all new staff along with on-going education and on-the-job training opportunities.

All MHS candidates are required to have an Ohio BCI check (FBI check required if you have lived in Ohio for less than 5 years or for working with children) 5-panel drug screen and residential staff must have 2 step TB (or proof of prior TB) upon conditional offer of employment.

Required Experience:

REVENUE CYCLE SPECIALISTFT 40 hours per weekMonday-FridayThe Revenue Cycle Specialist supports claims timely cash posting and denial prevention/resolution across outpatient community-based telehealth and (if applicable) inpatient psychiatry services. This role blends day-to-day billing work (eligibi...