Revenue Cycle Specialist

Acadia Healthcare; Providence (RI); Remote; USD 42,000 - 65,000; Full time

Benefits offered by this job

Medical, Dental & Vision insurance

401(k) with company match

Life insurance & short-term disability

Generous PTO & sick leave

Employee Assistance Program (EAP)

Career advancement opportunities

Job summary

Acadia Healthcare is hiring a Revenue Cycle Specialist to support billing, authorization verification, and reimbursement processes across a nationwide network. The role emphasizes timely claims submission, payer communications, and meticulous documentation within a confidential, fast-paced environment.

Qualified candidates will have a high school diploma or equivalent, 2+ years in healthcare billing/AR, and strong MS Office skills.

Qualifications

• High school diploma or equivalent; some college or technical coursework preferred.
• 2+ years of healthcare billing/AR experience preferred.
• Healthcare payor claims follow-up or accounts receivable experience.
• Healthcare background with payor appeals experience.
• Advanced computer skills including Word, Excel, and PowerPoint.

Responsibilities

• Update patient Billing Episodes and credit accounts as appropriate.
• Review and resolve prior authorization/precertification/referral issues with insurers.
• Validate referrals/prior authorizations for scheduled services and share with staff.
• Document all account activity in the system and communicate with staff.
• Manage clinic emails and respond in a timely manner.
• Identify and forward potential reimbursement problems to Revenue Cycle Manager.
• Interact with clinics and staff to share benefits, authorizations, and eligibility.
• Bill patient claims in a timely manner (weekly billing, secondary/out-of-network).
• Review claims issues, make corrections, rebill via claims clearinghouse, EMRs and payor portals.
• Evaluate bill cycles and update as needed.
• Print daily billing reports and monitor validation percent.
• Work daily on rejection lists from eligibility and coordination of care.
• Gather and interpret data to determine action steps for payment.
• Call and status outstanding claims with third party payors.
• Review EOBs to ensure correct processing and payment.
• Document account follow-up actions.
• Identify trends and work with Revenue Cycle Manager for resolution.
• Perform other duties as assigned.

Skills

Healthcare billing/AR

Payor appeals

MS Office (Word/Excel/PowerPoint)

Confidential data handling

Interpersonal skills

Multitasking under deadlines

Education

High school diploma or equivalent

Tools

Microsoft Office

Job description

Overview

Now Hiring: Revenue Cycle Specialist

Remote in USA - WORKING EST

Our Network That Serves Nationwide:

Acadia Healthcare's Comprehensive Treatment Centers (CTC) division operates 170+ CARF-accredited outpatient opioid treatment programs (OTPs) nationwide, serving patients undergoing treatment for opioid use disorder (OUD). As the leading provider of medication-assisted treatment (MAT) in the nation, we care for more than 74,000 patients daily. Our mission is to deliver comprehensive care, combining therapies with safe and effective medications. Our team stands at the forefront of the battle against the opioid epidemic.

Hours: Monday- Friday (7am-5pm EST working 8 hours within this timeframe)

Our Benefits:

• Comprehensive Medical, Dental, & Vision insurance
• Competitive 401(k) plan with company match
• Company paid group term life insurance and short-term disability
• Generous PTO: Paid vacation, personal time, sick Leave, and extended sick leave
• Employee Assistance Program(EAP) offering continued support to employee lifestyle and well-being
• Career advancement opportunities across a leading national network

Job Responsibilities:

• Responsible for updating patient Billing Episodes and crediting account, as appropriate.
• Review and resolve prior authorization/precertification/referral issues that are not valid and contact insurance carriers to verify/validate requirements to ensure accuracy and avoid potential denial.
• Validates all necessary referrals/prior authorizations/pre-certifications for scheduled services are on file and shared with all appropriate staff and are valid for the scheduled services performed.
• Ensure all account activity is documented in the appropriate system and shared with all appropriate staff timely and thoroughly.
• Clinic Emails - responsible for managing clinic emails throughout the day. All clinic emails must be responded to in a timely manner.
• Identify, Correct and forward potential reimbursement problems to Revenue Cycle Manager.
• Proactively interacts with Clinics and other appropriate staff sharing benefits, authorizations, and eligibility.
• Responsible for billing all patient claims in a timely manner (weekly billing, secondary and out-of-network plans).
• Review claims issues make corrections as needed and rebill. Utilize claims clearinghouse, EMRs and payor portals to review and correct claims and to resubmit electronically when available.
• Responsible for evaluating bill cycles and changing/updating when necessary.
• Responsible for printing daily billing reports - both electronic and paper claims. Monitor validation percent.
• Work daily claims rejection lists including but not limited to; claims rejected due to auto eligibility process during weekly billing and Rejected claims due to eligibility, coordination of care and authorization as part of accounts receivable.
• Gathers and interprets data from the system and understands appropriate courses of action to take and initiates time-sensitive and strategic steps resulting in payment.
• Call and status outstanding claims with third party payors.
• Review explanation of benefits to ascertain that claim processed and paid correctly.
• Document account follow-up where appropriate.
• Identify trends and work with the Revenue Cycle Manager for resolution.
• Perform other duties as assigned.

Qualifications

Your Education, Skills, & Qualifications:

• High school diploma or equivalent; prefer some college or technical school coursework.
• 2+ years of healthcare billing/AR experience, preferred.
• Healthcare payor claims follow-up or accounts receivable experience.
• Healthcare background with payor appeals experience.
• Advanced computer skills including Microsoft Office; especially Word, Excel, and PowerPoint.
• Knowledge of office administration procedures with the ability to operate most standard office equipment.
• Ability to work professionally with sensitive, proprietary data & information while maintaining confidentiality.
• Excellent interpersonal skills include the ability to interact effectively and professionally with individuals at all levels; both internal and external.
• Exercises sound judgment in responding to inquiries; understands when to route inquiries to the next level.
• Self-motivated with strong organizational skills and superior attention to detail.
• Must be able to manage multiple tasks/projects simultaneously within inflexible time frames. Ability to adapt to frequent priority changes.
• Capable of working within established policies, procedures and practices prescribed by the organization.
• English sufficient to provide and receive instructions/directions.

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