Revenue Cycle Management Specialist

Job Description

Job Description

Benefits:

• 401(k)
• 401(k) matching
• Competitive salary
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off
• Vision insurance

About Ellie Mental Health of Aurora and Saint Charles:
Ellie Mental Health of Aurora and St. Charles is dedicated to providing compassionate, accessible, and high-quality behavioral health services to our communities. We strive to make mental health care approachable, inclusive, and effective, fostering a supportive environment for both clients and staff. Join our team to help ensure the financial health of our clinics while supporting our mission to improve mental wellness.

Position Overview:
The Revenue Cycle Management (RCM) Specialist is a critical member of the Ellie Mental Health of Aurora and St. Charles team, responsible for managing the end-to-end revenue cycle process to ensure timely and accurate billing, collections, and financial reporting. This role requires a detail-oriented individual with strong analytical skills, knowledge of behavioral health billing practices, and a commitment to supporting the clinics mission. The RCM Specialist will handle claims creation, bill submission, payment posting, resolution of problematic claims, and report generation to optimize revenue and ensure compliance with insurance and regulatory requirements.

Key Responsibilities:
Claims Creation and Submission:

• Prepare and submit accurate insurance claims for behavioral health services using the clinics electronic health record (EHR) and billing software.
• Verify patient insurance eligibility and benefits prior to claim submission.
• Ensure claims are coded correctly (e.g., CPT, ICD-10) in compliance with payer requirements and behavioral health regulations.

Bill Dropping:

• Generate and submit clean claims to insurance payers and self-pay clients in a timely manner.
• Monitor claim submission processes to ensure accuracy and compliance with payer deadlines.

Payment Posting:

• Accurately post payments, adjustments, and denials received from insurance companies and patients.
• Reconcile payments with claims to ensure proper account balancing and identify discrepancies.

Problematic Claims Resolution:

• I dentify, analyze, and resolve denied or rejected claims by working with insurance companies, patients, and clinical staff.
• Appeal denied claims as needed, ensuring proper documentation and timely follow-up.
• Address underpayments, overpayments, or coding errors to maximize reimbursement.

Reporting and Analysis:

• Generate regular financial and performance reports, including accounts receivable (A/R) aging, claim status, and revenue cycle metrics.
• Analyze trends in denials, reimbursements, and billing issues to recommend process improvements.
• Provide insights to the Clinic Manager and Clinic Director to support financial decision-making and operational efficiency.

Compliance and Documentation:

• Ensure all billing practices comply with federal and state regulations, including HIPAA, and payer-specific guidelines.
• Maintain accurate and organized documentation for all claims, payments, and correspondence.

Collaboration and Communication:

• Work closely with clinical staff to verify documentation and coding accuracy for services rendered.
• Communicate with patients regarding billing inquiries, payment plans, and insurance-related questions in a professional and empathetic manner.
• Collaborate with the billing team, Clinic Manager, and Clinic Director to streamline workflows and improve revenue cycle efficiency.

Additional Duties:

• Stay updated on changes in insurance policies, billing regulations, and behavioral health coding standards.
• Assist with audits and provide documentation as needed for compliance reviews.
• Support the implementation of new billing software or processes as required.
• Perform other administrative tasks as assigned to support the clinics operations.

Qualifications:
Education and Experience:

• High school diploma or equivalent required; associates or bachelors degree in healthcare administration, business, or related field preferred.
• Minimum of 2 years of experience in medical billing or revenue cycle management, preferably in behavioral health or mental health settings.
• Certification as a Certified Professional Coder (CPC) or Certified Billing and Coding Specialist (CBCS) is a plus.

Skills and Abilities:

• Strong knowledge of medical billing, coding (CPT, ICD-10), and insurance processes, with specific experience in behavioral health billing preferred.
• Proficiency in EHR and billing software (e.g., TherapyNotes, Kareo, or similar platforms); familiarity with the Valant EHR platform is a plus .
• Excellent attention to detail and organizational skills to manage high volumes of claims and data.
• An analytical mindset with the ability to identify and resolve complex billing issues.
• Strong communication skills, both written and verbal, to interact with payers, patients, and staff.
• Ability to work independently and collaboratively in a fast-paced environment.
• Familiarity with HIPAA and other healthcare regulations.

Personal Attributes:

• Empathetic and patient-focused approach to handling sensitive client interactions.
• Problem-solving mindset with a proactive attitude toward challenges.
• Commitment to Ellie Mental Healths mission of providing accessible and compassionate care.

Work Environment:

• This position is primarily office-based, with responsibilities split between Ellie Mental Health locations in Aurora, IL, and St. Charles, IL, with the potential for hybrid or remote work depending on clinic needs and performance.
• Standard office hours with occasional flexibility required to meet deadlines or resolve urgent billing issues.

Benefits:

• Competitive salary commensurate with experience.
• Health, dental, and vision insurance options.
• Paid time off and holidays.
• Opportunities for professional development and continuing education.
• Supportive and collaborative team environment.

Flexible work from home options available.