Revenue Cycle Specialist

Bravehealth; États-Unis; À distance; USD 60 000 - 80 000; Plein temps

Résumé du poste

Brave Health is seeking a detail-oriented Revenue Cycle Management Specialist to ensure accurate billing and timely claims submission across Commercial, Medicaid, and Medicare. This 100% remote role supports multiple states and collaborates with the Insurance Verification team to optimize cash flow.

You will handle denials, resubmissions, collections, and patient inquiries, leveraging expertise in healthcare coding and compliance to minimize denials and improve revenue cycle performance.

Qualifications

• High school diploma or GED.
• 3+ years of RCM experience with strong accounts receivable knowledge.
• Ability to analyze claims data to identify trends and mitigation opportunities.
• Experience in digital or virtual health environments.
• Proficiency with medical billing systems (e.g., Candid Health, Healthie).
• Extensive experience in healthcare accounts receivable and collections.
• Strong attention to detail and prioritization, with excellent communication skills.
• Knowledge of Medicaid, Medicare, and commercial billing requirements.
• HIPAA and regulatory compliance understanding.

Responsabilités

• Denial and Claims Management: identify trends, research unpaid or denied claims, and coordinate with payers; handle EDI transactions and payer submissions.
• Collections and Payment Resolution: perform collection activities per payer guidelines and document actions; review posted payments and post adjustments.
• Customer Support and Continuous Improvement: monitor patient accounts for non-payment and respond to billing inquiries; collaborate with teams to implement process improvements.

Connaissances

RCM experience

Claims data analysis

Digital health

Medical billing systems

Accounts receivable

Attention to detail

Communication skills

Customer service

HIPAA compliance

Medicaid/Medicare billing

Formation

High School Diploma

Outils

Candid Health

Healthie

Description du poste

Why We're Here:

At Brave Health, we are driven by a deep commitment to transform lives by expanding access to compassionate, high-quality mental health care. By harnessing the power of technology, we break down barriers and bring mental health treatment directly to those who need it most-wherever they are. As a community health-centered organization, we are dedicated to ensuring that no one is left behind. Nearly 1 in 4 people in the U.S. receive healthcare through Medicaid, yet two-thirds of providers don't accept it. Brave Health is stepping up to close this gap by making mental health care accessible, affordable, and life-changing for all.

Overview:

Under the direction of the Supervisor of Revenue Cycle Management, the Revenue Cycle Management (RCM) Specialist is responsible for ensuring accurate billing and the timely submission of electronic and paper claims. This role includes monitoring claim status, researching and resolving denials or rejections, documenting account activities, and posting adjustments and collections. The RCM Specialist must demonstrate strong critical thinking skills and possess in-depth knowledge of Commercial, Medicaid, and Medicare eligibility requirements and contract guidelines.

Key Responsibilities:

• Denial and Claims Management:
  Identify and analyze denial trends, using findings to suggest process and system improvements to prevent future issues
  Research and resolve unpaid, denied, and rejected claims, including communication with payers and submitting denials as needed
  Handle EDI transactions, including reconciliation of payer submissions, edits, and rejection reports
  Partner closely with the Insurance Verification team to identify upstream impacts on claim processing
  Collaborate effectively with team members and other departments to support organization goals and implement process improvements
• Collections and Payment Resolution:
  Complete collection activities in compliance with payer guidelines and filing limits, ensuring actions are thoroughly documented
  Review posted payments and process account adjustments as appropriate
• Customer Support and Continuous Improvement:
  Monitor patient accounts for non-payment, delayed payment, and billing irregularities, maintaining accurate records and taking appropriate steps for resolution
  Investigate and respond to patient billing inquiries

Competencies, Skills & Experience Required:

• High school diploma or GED
• 3+ years of RCM experience, with a strong preference for familiarity with accounts receivable processes
• Ability to analyze claims data to spot trends and suggest mitigation strategies
• A history of working in digital or virtual health
• Use of medical billing systems (i.e. Candid Health, Healthie)
• Extensive experience in healthcare accounts receivable and collections
• Strong attention to detail with a focus on accuracy and prioritization
• Excellent oral and written communication skills across internal and external stakeholders
• Proven customer service abilities in resolving patient and payer inquiries
• Working knowledge of medical coding principles, denials, and payer-specific requirements
• Ability to thrive in a fast-paced, high-volume environment
• Commitment to adhering to HIPAA and regulatory compliance guidelines
• In-depth understanding of Medicaid, Medicare, and commercial insurance billing processes

Preferred Skills:

• A background in mental or behavioral health billing
• Fluent in Spanish
• Proficient in Microsoft Excel and Word

Work Schedule:

This is a full-time, 100% remote position. Applicants hired into this position can work from most states and will work Monday - Friday.

Brave Health is very proud of our diverse team who cares for a diverse population of patients. We are an equal opportunity employer and encourage all applicants from every background and life experience to apply.