Revenue Cycle Specialist

Exact Billing Solutions is a unique team of revenue cycle management professionals specializing in the substance use disorder, mental health, and autism care fields of healthcare services. We have extensive industry knowledge, a deep understanding of the specific challenges of these markets, and a reputation for innovation. With our proprietary billing process, EBS is the oil that brings life to the engines of its partner healthcare companies.

Requirements

• Review and manage assigned AR inventory to ensure timely follow-up on outstanding claims.
• Investigate and resolve denials, rejections, and underpayments by working directly with payors, and internal teams.
• Submit corrected claims, appeals, and additional documentation as required to secure reimbursement.
• Document all collection activities clearly and accurately within our systems.
• Monitor payor trends and escalate recurring issues to leadership.
• Meet or exceed daily, weekly, and monthly productivity and quality standards.
• Support special projects and process improvement initiatives as assigned.
• Maintain effective communication with third-party insurance carriers to resolve issues that impede cash flow and detract from patient/member satisfaction
• Monitor and create reports on key metrics such as cash collections, days outstanding, unbilled claims, denials, daily census, etc.
• Status claims and add notes in the patient accounting system (CollaborateMD)
• Escalate any payor or client claim issues to department leadership
• Establish/maintain effective communications with the leadership team to ensure that all third-party guidelines are satisfied
• Update patient demographics and insurance information as needed
• Ability to meet KPI established metrics for productivity

Benefits

• 21 paid days off (15 days of PTO, which increases with tenure, plus 6 holidays).
• Flexible Spending Account (FSA) and Health Savings Account (HSA) options.
• Medical, dental, vision, long-term disability, and life insurance.
• Generous 401(k) with up to 6% employer match.