Revenue Cycle Specialist II

4 months ago


Houston, United States Senior PsychCare Full time
Job DescriptionJob DescriptionSalary: $20-$23 dollars per hour DOE

Senior PsychCare has an immediate opportunity for a Revenue Cycle Specialist II to support our Billing Team in Houston.


ABOUT US:

Senior Psych Care provides fully integrative behavioral health services to the long-term care patient, at their facility. Services include individual, family, and group therapies, along with diagnostic evaluation and collaborative intervention between the therapy team and the psychiatric team.

 

Job Description

Revenue Cycle Specialist II is responsible for processing follow-up actions on claims denied for eligibility-related reasons and responding to health plan correspondence. In this role, you would identify billing issues affecting the provider’s claims and take necessary action to ensure timely and appropriate claim filing. In addition, perform follow-up activities and identifies reimbursement issues affecting these claims. The Revenue Cycle Specialist also takes necessary actions to insure accurate reimbursement and account resolution.


Responsibilities :

  • Responsible for managing and maintaining a workload of approximately seventy (70) accounts or higher per day to ensure claim(s) resolution.
  • Leverage knowledge of Medicare, state Medicaid, and local coverage determinations (LCD’s) for claim resolution.
  • Review and attach appropriate documentation to resolve denied claims and submit appeals.
  • Call payers to determine the true reason for denial and inquire on what corrections need to be made.
  • Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or payer portals.
  • Review underpayments and overpayments, work with management to prepare spreadsheet and summarize findings; escalate as appropriate.
  • Prepare and submit denied claims targeted project files to payers, track reprocessing of project files.
  • Identify problematic claim trends and contract violations and report findings to the Manager and Director.
  • Contact insurers regarding recoupment payments, double debits, overpaid accounts, and missing checks; initiate dispute process as needed.
  • Update insurance information in the system as necessary, initiate and support primary, secondary and tertiary billing.
  • Perform other duties assigned by Revenue Cycle Manger.


This is a full-time, in-person opportunity. Our work week is from Monday-Friday 8am-5pm  (NO WEEKENDS Required).

 

Qualifications-Required Experience: 3+ years of recent Healthcare experience, specifically in a claims, Denials, billing, EOB and insurance verification. 

  • Minimum 1+ years’ experience in Government Payor follow- up (Required)
  • Ability to work independently and prioritize monthly workflow (Required)
  • Knowledge of Medical Terminology, CPT Codes, HCPCS, Revenue Codes, Modifiers and Diagnosis Codes (Required)
  • Payer portal and clearinghouse experience (Required)
  • Ability to work independently and prioritize monthly workflow (Required)
  • Mental Health experience (Preferred)


What we offer:

  • Paid Time Off and Paid Holidays
  • Comprehensive benefits packages including Medical, Dental, Vision, 401k, Long Term and Short-Term Disability, Life Insurance
  • Healthcare coverage available 1st day of the month following full-time employment.


All interested candidates are encouraged to apply. Apply today and START NEXT WEEK




  • Houston, Texas, United States Senior PsychCare Full time

    Job Title: Revenue Cycle Specialist IIJob Summary:Senior PsychCare is seeking a highly skilled Revenue Cycle Specialist II to join our Billing Team in Houston. As a key member of our team, you will be responsible for processing follow-up actions on claims denied for eligibility-related reasons and responding to health plan correspondence.Key...


  • Houston, Texas, United States Privia Health LLC Full time

    Job Description**About Privia Health LLC**Privia Health LLC is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings.**Job...


  • Houston, Texas, United States Transition Home Healthcare Full time

    Job Summary:The Director of Revenue Cycle is a key leadership position responsible for overseeing and optimizing the entire revenue cycle process at Transition Home Healthcare. This role involves managing billing, collections, coding, and financial operations to ensure timely and accurate reimbursement for services provided.Key Responsibilities:Revenue Cycle...


  • Houston, Texas, United States Sherloq Solutions Full time

    Medical Billing Specialist, Insurance Revenue CycleSherloq Revenue Solutions is seeking a highly skilled Medical Billing Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for resolving healthcare claims, verifying patient and insurance information, and analyzing payer denials.Key Responsibilities:Resolve...


  • Houston, Texas, United States Sherloq Solutions Full time

    Job SummarySherloq Solutions is seeking a highly skilled Medical Billing Specialist, Insurance Revenue Cycle to join our team. As a key member of our revenue cycle team, you will be responsible for resolving healthcare claims through verbal or online inquiries to health insurance payers.Key ResponsibilitiesEffectively navigate and utilize various healthcare...


  • Houston, Texas, United States Premier Medical Resources Full time

    Job SummaryPremier Medical Resources is a leading healthcare management company dedicated to delivering exceptional medical services. We are seeking a highly skilled Medical Accounts Recovery Specialist to join our team.The ideal candidate will possess a strong background in medical collection and revenue cycle management. As a Revenue Cycle Collections...


  • Houston, United States Transition Home Healthcare Full time

    Transition Home Healthcare is an elite home health agency serving Houston, TX and surrounding areas since 2010. We are a group of passionate people dedicated to delivering the highest quality services to our patients, families, team members, and the community. Our team is growing and looking for an experienced: Director of Revenue Cycle Job Summary: The...


  • Houston, Texas, United States Privia Health Full time

    Job DescriptionCompany OverviewPrivia Health is a leading technology-driven company that collaborates with medical groups, health plans, and health systems to optimize physician practices, improve patient experiences, and reward doctors for delivering high-value care in both in-person and virtual settings.The Privia Platform is a scalable operations and...


  • Houston, Texas, United States Inception Fertility Corporate Services Full time

    Job OverviewInception Fertility Corporate Services is in search of a Chief Revenue Cycle Officer who will oversee the comprehensive management of all Revenue Cycle operations across North America. This executive will lead, coordinate, and execute initiatives to ensure the effective functioning of the organization's Revenue Cycle processes, aimed at...


  • Houston, United States Sherloq Solutions Full time

    SHERLOQ Revenue is looking to hire a full-time Medical Billing Specialist, Insurance Revenue Cycle. Are you looking to work for a high-energy, fast-paced company that fosters a team environment? Do you want to work where you will be respected and valued for what you contribute? An organization with a long history in the community for over 100 years! Well,...


  • Houston, United States Inception Fertility Corporate Services Full time

    Job DescriptionJob DescriptionInception is seeking a Senior Vice President of Revenue Cycle who will provide centralized management for all Revenue Cycle functions across US and Canada. The leader will direct, manage and implement programs to ensure efficient operations of the organization’s Revenue Cycle program in order to generate sufficient cash flow...


  • Houston, Texas, United States Memorial Hermann Health System Full time

    Job SummaryThe Revenue Cycle Management Manager will be responsible for leading the development and implementation of assigned projects, taking them from concept to final implementation. This includes defining project scope and objectives, developing detailed work plans, schedules, project estimates, resource plans, and status reports.This role will work...


  • Houston, Texas, United States Memorial Hermann Health System Full time

    Job SummaryThe Revenue Cycle Management Manager will be responsible for leading the development and implementation of assigned projects, taking them from concept to completion. This includes defining project scope and objectives, developing detailed work plans, schedules, project estimates, resource plans, and status reports. The successful candidate will...


  • Houston, Texas, United States Pailin Group Psc Full time

    Job Title: Senior Revenue Cycle Improvement ConsultantThe Pailin Group Psc is seeking a highly skilled Senior Revenue Cycle Improvement Consultant to join our team. As a key member of our revenue cycle team, you will be responsible for identifying, planning, leading, and implementing revenue cycle re-engineering solutions.Key Responsibilities:Lead revenue...


  • Houston, United States Pailin Group Psc Full time

    Senior Revenue Cycle Improvement Consultant The Senior Revenue Cycle Improvement Consultant identifies, plans, leads, and implements revenue cycle re-engineering solutions. The Senior Revenue Consultant works with revenue cycle departments including, but not limited to HIM, Access Services, Centralized Business Services, Charge Description Master, and...

  • Revenue Cycle Manager

    4 weeks ago


    Houston, Texas, United States Christus Health Full time

    Job SummaryThe Revenue Cycle Manager is responsible for overseeing the financial operations of the Revenue Cycle division at Christus Health. This includes managing and coordinating team efforts to ensure efficient and effective service delivery.Key ResponsibilitiesLeadership and Management: Provide coaching, feedback, and corrective action to team members...


  • Houston, Texas, United States Navient Solutions, LLC Full time

    Job SummaryXtend Healthcare LLC is a leading provider of comprehensive revenue cycle solutions to hospitals and health systems. We are committed to delivering solutions built around the broad revenue cycle needs of our clients.Key ResponsibilitiesResponsible for review and resolution of outstanding insurance balances on hospital or physician patient...

  • Credit Specialist

    3 weeks ago


    Houston, United States Baxter Full time

    This is where you save and sustain lives At Baxter, we are deeply connected by our mission. No matter your role at Baxter, your work makes a positive impact on people around the world. You’ll feel a sense of purpose throughout the organization, as we know our work improves outcomes for millions of patients. Baxter’s products and therapies are found in...


  • Houston, Texas, United States Inception Fertility Corporate Services Full time

    Job DescriptionJob Summary:Inception Fertility Corporate Services is seeking a highly experienced Senior Vice President of Revenue Cycle Operations to lead our revenue cycle functions across the US and Canada. The ideal candidate will have a proven track record of managing revenue cycle activities to ensure cost effectiveness, organizational efficiency, and...


  • Houston, Texas, United States Baxter Full time

    About This RoleBaxter is a leading healthcare company that is deeply connected by its mission to save and sustain lives. As a Revenue Cycle Manager, Denials and Collections, you will play a critical role in leading and overseeing the strategic direction, operations, and performance of the Reimbursement Services team.Key ResponsibilitiesLead the RCM...