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Job description
This position is a hybrid schedule: Three days in the office/clinic and two days working from home.
Starting pay range $25.00/hr - $27.00/hr depending on experience, plus annual bonus potential.
Behavioral Health Group (BHG) is the largest network of Joint Commission-accredited treatment centers and a leading provider of opioid addiction treatment services. With over 116 locations in 24 states and a team of more than 1,900 employees, we are dedicated to helping individuals overcome substance use disorders and reclaim their lives. Join us in making a difference.
Job Summary
This position will act as a key member of the Revenue Cycle Department and reports to the Director, Contract and Revenue Cycle. The Revenue Cycle Specialist will help facilitate claims, payments, and verifications daily. The Revenue Cycle Specialist will provide updates and reports on the financial stability of the treatment centers. The
Revenue Cycle Specialist will be responsible for reviewing claims data to ensure insurance requirements, eligibility, prior authorizations and proper signatures are secured prior to submission. Submits claims in an organized sequence in order to achieve reimbursement from private payers, insurance companies and government healthcare programs with heavy concentration in Medicaid. Will investigate declined claims through research and applicable correspondence in order to successfully resolve payment discrepancies.
Summary of Essential Job Functions
The key responsibilities of the Revenue Cycle Specialist include but not limited to:
Duties and Responsibilities
Reviews claims data to ensure 3rd party billing requirements are met
Reviews claims to ensure eligibility, prior authorizations and proper signatures
Submits claims in an organized sequence in order to achieve reimbursement from private payers, insurance companies and government healthcare programs Medicaid, VA, etc.)
Investigates denied claims through research and applicable correspondence and follows through to resolution
Successfully resolves payment discrepancies in a timely manner
Escalates issues appropriately and promptly to supervision
Verifies and informs treatment center staff about the patient's financial accountability and 3rd party reimbursement, as applicable
Posts payments and adjustments while ensuring all deposits are balanced daily
Documents payment records and issues as they occur
Completes reporting requirements as required by company policy and requested by supervision
Demonstrates an understanding of NPI, taxonomy and electronic claim submission requirements
Identifies underpayments and overpayments/credits to determine steps for resolution
Retrieves missing payment information from payers through various methods (phone, payer portals, clearing houses, etc.)
Reads debits and credits on accounts and takes necessary action to resolve
Performs other duties assigned by supervision
Regulatory Responsible for complying with all federal, state and local regulatory agency requirements
Responsible for complying with all accrediting agencies
Marketing and Outreach
Participate in community and public relations activities as assigned.
Professional Development
Responsible for the achievement of assigned specific annual goals and objectives
Demonstrates the belief that addiction is a brain disease, not a moral failing
Demonstrates hope, respect, and caring in all interactions with patients and fellow Team Members
Establishes and maintains positive relationships in the workplace
Can work independently and under pressure while handling multiple tasks simultaneously
Makes decisions and uses good judgment with confidential and sensitive issues
Deals appropriately with others in stressful or other undesirable situations
Training Participate in and provide in-service trainings as required by federal, state, local, and accrediting agencies
Attend conferences, meetings and training programs as directed
Participate in and/or schedule and attend regular in-service trainings
Other Demonstrated commitment to valuing diversity and contributing to an inclusive working and learning environment
Qualifications
The Revenue Cycle Specialist must have the following qualifications. High school Diploma or equivalent
At least 2 years of RCM experience, specifically in AR with government and commercial payors.
In addition to meeting the qualifications, the ideal candidate will embody the following characteristics and possess the knowledge, skills and abilities listed below: High integrity
Excellent verbal and written communication skills
Sound judgment
Efficient
Self-starter
Strong interpersonal communication skills
Valid driver's license.
Healthcare experience preferred.
Experience in front desk, admissions, billing, and/or collections.
Excellent verbal and written communication skills.
Strong customer service and interpersonal communication skills.
Accurate data entry and basic keyboarding skills.
Ability to work independently under pressure and handle multiple tasks simultaneously.
Ability to enforce fee collection policies.
Basic computer/word processing skills.
Knowledge and use of typical office equipment (calculator, fax machine, copier, computer, telephone, postage meter, scales, scanner, and computer programs).
Knowledge of basic math, accounting, and accounts receivable.
Physical Requirements and Working Conditions
The physical demands described here are representative of the requirements that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions to the extent such accommodation does not create an undue hardship on the business. Communicate effectively by phone or in person.
Vision adequate to read correspondence and computer screens.
Prolonged sitting, some bending, stooping, and stretching.
Manual dexterity for operating office equipment.
Variable workload and periodic high stress.
Standard medical office environment.
Interaction with patients with various health and legal issues.
Extended keyboarding periods.
Disclaimer
The above statements are intended to describe the general nature and level of work being performed by team members assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of team members so classified. All team members may be required to perform duties outside of their normal responsibilities from time to time, as needed, and this job description may be updated at any time.
BHG is an equal opportunity, affirmative action employer providing equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law.
Why Join BHG?
Work-Life Balance: Enjoy generous paid time off, holidays, and personal needs. Benefit from flexible schedules with early in/early out hours, no nights, and no Sundays.
Investment in Your Growth: Prioritize your development with role-based training and advancement opportunities.
Comprehensive Benefits: Choose from three benefits programs, including health, life, vision, and dental insurance. Enjoy tuition reimbursement and competitive 401K match.
Recognition and Rewards: Experience competitive pay, quarterly bonuses, and incentives for certifications or licenses.
Employee Perks: Access exclusive discounts on various services and entertainment options, and benefit from our Employee Assistance Program and self-care series.
At BHG, we thrive on the greatness of our people. Join us and become part of a community that values excellence, integrity, and making a real difference in the lives of others.
BHG is an equal opportunity, affirmative action employer providing equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law.
Starting Pay Range: $23-$27
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.
Worksite address
minneapolis, MN, 55400, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.