RCM Specialist II

Ensora Health; East Honolulu (HI); Presencial; USD 60 000 - 78 000; Tempo integral

Resumo da oferta

Ensora Health in Hawaii is seeking an experienced RCM Specialist II to manage accounts, resolve complex billing issues, and drive positive financial outcomes for behavioral health practices.

You will resolve denials, monitor performance with analytics, and partner closely with clinicians and practice owners to deliver proactive account management and excellent service. This role emphasizes process improvement and data-driven decisions.

Qualificações

• Associate degree or equivalent education and experience.
• 1 year medical billing or revenue cycle management experience.
• 1 year of customer service, account management, or client-facing experience.
• Strong understanding of insurance billing, behavioral health billing, and therapy reimbursement processes.
• Working knowledge of claims submission, payment posting, denial management, appeals, and AR follow-up.
• Strong analytical and problem-solving skills with a customer-first mindset.
• Excellent verbal and written communication skills with the ability to manage multiple priorities.

Responsabilidades

• Submit, review, correct, and process denied, rejected, and unpaid claims with accuracy and timely resolution.
• Research and resolve claim issues by identifying root causes and proposing solutions.
• Prioritize and manage a high-volume workload based on age, complexity, and urgency.
• Own accounts receivable for assigned accounts; use reports to monitor performance and identify improvements.
• Partner with clinicians, practice owners, and customers for proactive account management.
• Build trusted relationships through meetings, written communication, and ongoing contact.
• Identify trends and denial patterns while recommending process improvements.
• Use technology to streamline workflows and improve productivity.
• Collaborate with Leads and Managers to share knowledge and support a culture of improvement.
• Stay current on payer requirements and best practices to support customer success.

Conhecimentos

Medical billing

Revenue cycle management

Customer service

Account management

Insurance billing

Therapy reimbursement

Analytical skills

Communication skills

Formação académica

Associate degree or equivalent

Ferramentas

Billing systems

Reporting tools

Microsoft Office

Descrição da oferta de emprego

Ensora Health is the leading provider of software and services for mental and behavioral health therapists, trusted by over 200,000 individual providers and more than 28,000 practices. Our unmatched expertise, partnership, and breadth of products allow us to fine-tune solutions that meet the specific needs of everyone from solo practitioners to larger practices. With AI-enabled solutions that span practice management to electronic medical records and e-prescribing to billing, we help eliminate administrative complexity and create harmony between therapists, their clients, and the whole healthcare community.

Job Description

At Ensora Health, our Revenue Cycle Management team plays a vital role in helping behavioral health providers focus on what matters most: delivering quality care to their clients. As an RCM Specialist II, you will serve as a trusted partner to clinicians and practice owners by managing accounts, resolving complex billing challenges, and driving positive financial outcomes.

We're looking for someone who is detail-oriented, analytical, and forward-thinking, with a passion for problem-solving and continuous improvement. The ideal candidate embraces technology, seeks opportunities to optimize processes, and thrives in a collaborative, fast-paced environment where they can make a meaningful impact for customers.

What You'll Do

• Submit, review, correct, and process denied, rejected, and unpaid insurance and healthcare claims with a focus on accuracy and timely resolution.
• Research and resolve claim issues by identifying root causes, recommending solutions, and collaborating with internal and external stakeholders.
• Effectively prioritize and manage a high-volume workload based on claim age, complexity, customer impact, and urgency.
• Own the accounts receivable process for assigned accounts, leveraging reporting, analytics, and account reviews to monitor performance and identify opportunities for improvement.
• Partner closely with clinicians, practice owners, and customers to provide proactive account management and exceptional service.
• Build trusted relationships through regular meetings, strategic account discussions, written correspondence, and ongoing communication.
• Identify trends, denials, and reimbursement challenges while recommending process improvements that enhance operational efficiency and customer outcomes.
• Utilize technology and available tools to streamline workflows, improve productivity, and support data-driven decision making.
• Collaborate with team members, Leads, and Managers to share knowledge, solve complex issues, and contribute to a culture of continuous improvement and service excellence.
• Stay current on payer requirements, industry changes, and revenue cycle best practices to support customer success.
• Perform other duties as assigned.

What You Bring

Required Qualifications

• Associate degree or equivalent combination of education and experience.
• Minimum of 1 year of medical billing or revenue cycle management experience.
• Minimum of 1 year of customer service, account management, or client-facing experience.
• Strong understanding of insurance billing, behavioral health billing, and therapy reimbursement processes.
• Working knowledge of the healthcare revenue cycle, including claims submission, payment posting, denial management, appeals, and accounts receivable follow-up.
• Strong analytical and problem-solving skills with the ability to investigate issues and identify effective solutions.
• Excellent verbal and written communication skills with a customer-first mindset.
• Ability to manage multiple priorities while maintaining a high level of accuracy and attention to detail.
• Proficiency with billing systems, reporting tools, and Microsoft Office applications.

Additional Information

While we’ve outlined some key qualities we typically seek, it’s essential to remember that there might be additional unique strengths and talents you possess that would make you an exceptional match for us, even if they are not explicitly mentioned. Studies have consistently highlighted the significance of this principle, particularly for individuals from disenfranchised backgrounds, including women and other marginalized groups. These individuals often hesitate to apply unless they meet every single requirement, unlike their male counterparts who are more inclined to apply when they meet around 60% of the criteria.

The message we want to convey is that taking a leap of faith and applying can be incredibly rewarding. Your distinct abilities and perspectives could be exactly what we need to create a more diverse and inclusive team. So, don't hesitate—apply today and let's explore the exciting possibilities together!

All your information will be kept confidential according to EEO guidelines.

At En sora Health , Diversity, Equity, Inclusion, and Belonging aren't just words. We celebrate what makes us unique, foster an ecosystem of inclusion for all and harness our talents to promote diversity of thought and action in everything we do.

We instill Diversity, Equity, Inclusion, and Belonging into the fabric of our CARING culture and business, as we strive to be recognized not only as the leader in healthcare technology, but also for our intentional efforts to promote a diverse community.

We will champion non-discriminatory practices throughout the employee and customer lifecycle; caring for every person regardless of race, national origin, color, religion, disability, sex, orientation, or familial status.

Ensora Health is an equal opportunity employer.