Revenue Cycle Specialist at Walker Health Services, LLC – Pikesville, Maryland
Walker Health Services, LLC
Pikesville, Maryland, 21208, United States
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About This Position
Walker Health Services
Job Title: Revenue Cycle Specialist
Job Summary:
Walker Health Services is seeking a full-time, experienced Revenue Cycle Management (RCM) professional to join our team. The Revenue Cycle Specialist will manage end-to-end revenue cycle processes, including patient Verification of Benefits (VOBs), utilization reviews, billing, coding, claims processing, payment posting, and collections. The individual in this role will work closely with clinical, administrative, and financial teams to ensure efficient and accurate revenue generation and collection. This position specifically requires expertise in the submission of residential, ancillary, and outpatient substance use disorder claims and filing procedures.
Walker Health Services is seeking a full-time, experienced Revenue Cycle Management (RCM) professional to join our team. The Revenue Cycle Specialist will manage end-to-end revenue cycle processes, including patient Verification of Benefits (VOBs), utilization reviews, billing, coding, claims processing, payment posting, and collections. The individual in this role will work closely with clinical, administrative, and financial teams to ensure efficient and accurate revenue generation and collection. This position specifically requires expertise in the submission of residential, ancillary, and outpatient substance use disorder claims and filing procedures.
Key Responsibilities:
- Revenue Cycle:
- Perform VOBs, utilization reviews, submit claims, and conduct follow-ups, taking full responsibility until tasks are delegated.
- Spearhead billing and coding to ensure accurate and timely submission of claims to insurance providers.
- Respond to claim rejections and denials to address and resolve them promptly.
- Ensure that claims are properly submitted for all services rendered.
- Use electronic medical records systems (e.g., Kipu EMR, Alleva) to manage patient data, billing information, and claims processing.
- Collect and review all patient insurance information needed to complete the benefit verification process.
- Use portals and online resources (e.g., Availity, UHC) to confirm policy status and eligibility.
- Collaborate in obtaining prior authorization, claim appeals, etc.
- Report trends and delays to Management.
- Utilization Review:
- Complete pre-authorization and concurrent reviews for all levels of care in a timely manner.
- Collaborate with team members to gather required information for completing concurrent reviews.
- Manage, improve, and optimize the EMR documentation that contributes to the utilization review process.
- Ensure all days for each client are authorized timely and appropriately communicated to the team.
- Maintain necessary data for completing reviews and tracking existing and future reviews.
- Coordinate peer-to-peer review calls with clinic staff and utilization review representatives as needed.
- Prepare and submit appeal documentation (including rationales) to the appropriate entities.
- Financial Performance:
- Collaborate with finance and accounting teams to reconcile payments, post adjustments, and ensure accurate financial reporting.
- Assist in the development of key performance indicators (KPIs) related to revenue generation, billing efficiency, and collection rates.
- Compliance and Technology:
- Stay current with industry regulations, payer policies, and coding guidelines to ensure compliance.
- Develop and maintain a strong understanding of behavioral health billing and coding practices specific to the facility's services.
- Assist with the implementation of revenue cycle software solutions and technologies to streamline processes and enhance efficiency.
- Identify opportunities for automation and process optimization within the revenue cycle.
Additional Information:
This job description is intended to provide a general overview of the responsibilities and requirements for the role. The employee may be required to perform other related duties as necessary to meet the organization’s ongoing needs.
This job description is intended to provide a general overview of the responsibilities and requirements for the role. The employee may be required to perform other related duties as necessary to meet the organization’s ongoing needs.
How to Apply:
If you meet the qualifications and are seeking a great opportunity in the field of revenue cycle management, Walker Health Services encourages you to apply. Please submit your resume and a cover letter detailing your relevant experience.
If you meet the qualifications and are seeking a great opportunity in the field of revenue cycle management, Walker Health Services encourages you to apply. Please submit your resume and a cover letter detailing your relevant experience.
Job Type: Full-time
Experience Required:
- 3-5 years of experience in revenue cycle management and behavioral health billing and coding.
Location Requirements:
- Must be able to commute to Pikesville, MD 21208 (Required).
Work Location: Hybrid
Salary: $65,000 - $75,000
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Job Location
Pikesville, Maryland, 21208, United States
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