Revenue Cycle Specialist Lead

Reports to: Revenue Cycle Director

FLSA Status: Exempt/Full Time

Location: In-person at our corporate office is required for individuals who are located in San Antonio or surrounding areas, remote will be considered if not located in San Antonio. In order to be eligible for remote candidates must live in one of the following states: Texas, Georgia, Florida, Louisiana, Tennessee, Mississippi or Alabama.

Job Summary:

The Revenue Cycle Specialist Lead at Empower Behavioral Health (EBH) is a key member of the revenue cycle management team. This individual is responsible for overall claim follow-up, denial management and appeals tracking. Ensuring that our cash flow is consistent and denial trends are tracked and reported. Working in a fast-paced, growing organization, this position is focused on the ever-growing needs of the EBH billing team in line with the EBH standard of patient care. This position will rely heavily on communication and multi-tasking abilities.

Duties and Responsibilities:

• Oversee end-to-end accounts receivable (AR) workflows, ensuring timely follow-up, resolution, and optimization of outstanding claims
• Lead denial management and claim recovery efforts, including root cause analysis, appeal strategy, and resolution tracking to maximize reimbursement
• Analyze cash flow trends, payment variances, and payer performance to identify risks and opportunities for revenue improvement
• Prepare, review, and submit claims in alignment with payer requirements and organizational standards
• Manage payment posting and reconciliation of Explanation of Benefits (EOBs), ensuring accuracy and completeness of financial data
• Retrieve and reconcile remittances from payer portals to support accurate cash application and reporting
• Communicate directly with payers to resolve claim issues, submit technical appeals, and address underpayments or denials
• Monitor daily billing and AR activities to ensure productivity standards and timely claim progression
• Compile and deliver month-end reporting, including AR aging, denial trends, and cash performance insights for leadership review
• Facilitate monthly revenue cycle or billing meetings, providing actionable insights and updates on key performance indicators
• Research and prepare documentation required for appeals and audits, ensuring compliance with payer and regulatory requirements
• Identify denial trends and implement corrective action plans to improve first-pass resolution rates and reduce rework

Competencies:

• Planning and Evaluating (Workload Management)
• Problem Solving
• Attention to Detail
• Results-Oriented
• Customer Service
• Oral and Written Communication

Education and Experience:

Required:

• High school diploma or equivalent
• Minimum of one year of healthcare professional billing experience
• Previous experience with Claim Submission Requirements
• Experience with revenue cycle and how various components work together
• Experience or exposure to any Practice Management Software
• Experience with a large number of taking inbound and outbound calls while maintaining a professional manner

Preferred:

• Experience with Central Reach practice management system
• Experience working in an administrative setting
• Experience working in a growing organization

Physical Requirements:

• Must be able to sit for extended periods while working at a desk or computer
• Must be able to stand, walk, and move about the office as needed
• Must be able to use hands and fingers to operate a computer, keyboard, mouse, telephone, and other office equipment
• Must be able to reach, bend, handle, and manipulate office materials and equipment
• Must be able to lift and carry office supplies, packages, and materials weighing up to 15 pounds
• Must be able to see, read, and interpret written documents, computer screens, and data for extended periods of time
• Must be able to hear and communicate effectively in person, over the phone, and via electronic means

Empower Behavioral Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.