Revenue Cycle Specialist (Insurance Eligibility Verification Specialist)

Behavioral Health Revenue Cycle Management Solutions, LLC

Job Title: Level 1 RC Specialist (Insurance Eligibility Verification Specialist...

Job Location: This is a remote job.

General Description of the Job

The revenue cycle specialist position provides comprehensive support for BHRCMS?s professional behavioral health revenue cycle operations. Other responsibilities may include obtaining and verifying authorizations, verify and update eligibility, and direct data entry of claims into payer portals for Behavioral Health Clients, the majority of which are in Massachusetts.

Duties and Responsibilities of this Level

Eligibility and Authorizations: The Level 1 Revenue Cycle Specialist will assist in perform Patient eligibility verification and obtaining authorizations from insurance companies and entering the authorization information into the Electronic Health Record systems.
? Verify insurance eligibility in payers portal to ensure the plan is active, client demographics match, and the coordination of benefits is aligned.
? Compile and submit Electronic Data Interchange files to insurance payers to confirm insurance policy details
? Download, review, and resolve errors identified in results received by the insurance payer in an Electronic Data Interchange file.
? Ensure plans are appropriately listed in the clients charts as per the Coordination of Benefits and date.
? Communicate with providers via email when insurance coverage changes and field questions as a result.
? Reprocess claims for rebilling to the correct payer if retroactive changes are made.
? Perform Quality Assurance tasks on your own work and reporting
? Attend trainings sponsored by insurance companies to stay up to date on changes.
? Experience with outpatient Behavioral Health insurance coverage is vital.
? Experience working with Google Sheets, Excel Spreadsheets, drafting emails is vital.
? Experience with performing claim adjustments to reprocess claims is essential.
? Experience working with CareLogic EHR is essential.
? Experience navigating in provider portals such as for CCA, Aetna, Cigna, Health
? New England, Tufts, and Medicare is important.
? Experience working on and communicating through requests submitted through a ticketing system is important.
? Experience with Massachusetts Medicaid products is important.
? Experience working with EDI file transmissions is preferred.

Perform other related duties incidental to the work described herein.

Supervisory Responsibility: No

Required Qualifications at this Level

Education: High School diploma or GED is required

Experience: Minimum of three years of billing/collection in healthcare preferred.

Knowledge, Skills, and Abilities:
? Massachusetts Behavioral Health billing knowledge preferred
? CareLogic EHR proficient preferred
? Denial management experience required
? Eligibility experience preferred
? Authorization experience preferred
? Microsoft Office ? Proficient - (Excel, Word)
? Good communication skills (verbal and written) are essential
? Detail-oriented, systematic, innovative
? Strong analytic and problem solving skills
? Must be able to meet deadlines, work independently, set priorities and maintain confidentiality
? Ability to work calmly and efficiently in high-pressure situations

The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform related tasks other than those specifically presented in this description.

Behavioral Health Revenue Cycle Management Solutions, LLC is an Affirmative Action/Equal Opportunity

Employer committed to providing employment and consulting opportunities without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

Behavioral Health Revenue Cycle Management Solutions, LLC is an at will employer.

Job Types: Full-time, Part-time

Pay: $16.00 - $19.00 per hour

Schedule:
? 8 hour shift
? Monday to Friday

Application Question(s):
? How many years of behavioral Health revenue cycle experience do you have?

Experience:
? Revenue cycle management: 1 year (Required)

Work Location: Remote

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