REVENUE CYCLE SPECIALIST FT, 40 hours per week Monday-Friday The Revenue Cycle Specialist supports claims, timely cash posting, and denial prevention/resolution across outpatient, community-based, telehealth, and (if applicable) inpatient psychiatry services. This role blends day-to-day billing work (eligibility, charge review, claim edits, payment posting, denials/appeals) with data-minded tasks (work queue monitoring, payer trend analysis). The Specialist partners closely with clinical, administrative, utilization review, and IT/HER teams to protect revenue and ensure compliance with HIPAA and 42 CFR Part 2. Responsibilities Patient Access & Financial Clearance •Perform financial registration for new outpatient and inpatient, ensuring accurate entry of information including documentation for contracted mental health boards. •Update financial records for existing patients as necessary. •Verify eligibility/benefits, document member cost-sharing, and flag coordination-of-benefits issues. •Track prior authorizations (initial/concurrent) and escalate risks to clinical leaders. Billing, Claims & Edits •Prepare and submit timely, compliant claims; resolve clearinghouse rejections and payer edit work queues. •Manage secondary/tertiary billing; meet timely filing limits per payer contracts. Cash Posting & A/R Follow-Up •Post remittances, reconcile unapplied cash, resolve credit balances/refunds, and support month-end close. •Work A/R follow-up queues by aging, balance, and denial category; document all touches thoroughly. Denials Management & Appeals •Classify denials (eligibility, authorization, coding, medical necessity, COB, late filing, frequency) and complete accurate, timely appeals. Other Responsibilities •Support Revenue Integrity Analyst in credentialing for all clinical staff and organizational facilities •Support front desk staff with coverage gaps •Treats patients and family with dignity and respect and holds all patient information in the strictest confidence. •Adhere to professional standards, policies and procedures, federal, state and local requirements and Joint Commission standards, including National Patient Safety Goals. Presents a positive image of MHSCC to other community agencies, caregivers and citizens •Completes all MHS required education and training, including initial agency orientation, mandatory training and education, and upkeep of all required certifications and licensures as required by state, federal and regulatory requirements. •Demonstrates organizational stewardship and exemplifies the mission, vision and values of MHS. •Performs other job-related tasks as assigned Education/Experience •High School Diploma or equivalent •Associate’s degree in accounting, business or related field preferred •1-3 years’ experience with medical billing preferred •Experience with Joint Commission, federal and state (Ohio) regulations and standards (preferred)
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