Revenue Cycle Specialist

Behavioral Health Services; Gardena (CA); On-site; USD 33,062 - 38,572; Full time

Job summary

Behavioral Health Services is seeking a detail-oriented professional for a full-time position in Gardena, CA. The role involves managing billing processes, analyzing claims, and ensuring compliance with healthcare regulations within a behavioral health setting. Candidates should possess a bachelor's degree and at least 3 years of experience in revenue cycle management.

Looking for strong analytical and communication skills, proficiency in Microsoft Excel, and familiarity with EHR systems. An ability to work collaboratively in a team-oriented environment is essential.

Qualifications

• Minimum of 3 years of experience in revenue cycle management within a healthcare setting.
• Proven track record in managing billing, collections, and accounts receivable processes.
• Experience with healthcare insurance claims processing and knowledge of payer requirements.

Responsibilities

• Conduct process improvement analysis and implement system improvements.
• Ensure adherence to billing and accounting regulations and guidelines.
• Analyze patterns in payer rejections and assist with proactive audits.

Skills

Analytical skills

Communication skills

Detail-oriented

Proficiency in Microsoft Office Suite

Problem-solving skills

Education

Bachelor’s degree in Healthcare Administration, Business, Finance, or related field

Tools

Microsoft Excel

Electronic Health Records (EHR) systems

Healthcare billing software

Job description

Job Details

• Level: Experienced
• Location: Gardena, CA 90249
• Position Type: Full Time
• Education Level: 4 Year Degree
• Salary Range: $24.00 - $28.00 Hourly
• Job Shift: Day
• Job Category: Accounting

Job Summary

Research and follow up on billing and payment Denials, Helds and other irregularities in a Behavioral Health Setting

Duties & Responsibilities

• Ongoing process improvement analysis and implementation of system improvements. Includes all activities within the scope of the Billing & Accounting Departments including charge/data entry, insurance follow up, and billing and collection of client balances.
• Adheres to Billing and Accounting regulations, company policy, HIPPA, 42CFR, CMS, DHCS, DPH/SAPC, DMH guidelines and statutes and contract requirements.
• Assist in identifying, analyzing and addressing challenges and/or breakdowns in the revenue cycle process.
• Perform ongoing trend analysis of payer rejections and denials. Assist in performing proactive audits on all recommended A/R write offs.
• Collaborate closely with other departments to contribute to cash reconciliation activities and to assist in the assessment of accounts receivable collectability and validation, including the writing off of bad debts.
• Assist with the review of contracted rates and reimbursements.
• Assist in the creation and development of reports to address management needs; analyze information to identify trends or issues.
• Work in multiple EHR systems.

Qualifications

Required Education

• Bachelor’s degree in Healthcare Administration, Business, Finance, or a related field. Equivalent experience may be considered in lieu of a degree.

Required Experience

• Minimum of 3 years of experience in revenue cycle management within a healthcare setting, preferably in behavioral health services.
• Proven track record in managing billing, collections, and accounts receivable processes.
• Experience with healthcare insurance claims processing and knowledge of payer requirements.
• Familiarity with electronic health records (EHR) systems and healthcare billing software.

Required Skills and Abilities

• Strong analytical skills with the ability to interpret financial data and generate actionable insights.
• Excellent communication skills, both written and verbal, with the ability to interact effectively with internal teams and external stakeholders.
• Detail-oriented with strong organizational skills to manage multiple tasks and priorities efficiently.
• Proficiency in Microsoft Office Suite, particularly Excel, for data analysis and reporting.
• Ability to work independently as well as collaboratively in a team-oriented environment.
• Knowledge of healthcare regulations and compliance standards, including HIPAA.
• Problem-solving skills with a proactive approach to identifying and resolving issues in the revenue cycle process.