RCM Specialist

To support the end-to-end revenue cycle in psychiatry and medication management, the full-time remote RCM Specialist will manage complex cases, ensure accurate coding and claim submissions, and drive process improvements within a Medicaid and managed-care environment.
Key Responsibilities

Improve first-pass claim acceptance by ensuring correct coding and submissions, while identifying and resolving denial trends
Collaborate with billing team members and vendors to manage complex patient cases, including reviewing clinical documentation and submitting claims
Ensure compliance with CMS, state Medicaid, and managed-care guidelines, while monitoring payer policy changes and optimizing coding practices

Required Qualifications

Minimum of 3 years of professional experience in medical coding and billing, with a preference for behavioral health claim management experience
Advanced proficiency with ICD-10, CPT, and HCPCS coding systems, along with experience in EHR systems and medical billing software
Strong understanding of payer patterns and healthcare compliance guidelines, including HIPAA
Analytical mindset with problem-solving expertise in addressing complex challenges and implementing improvements
Exceptional accuracy and attention to detail in coding, billing, and documentation processes