Overview
Join a mission-driven team dedicated to improving lives through innovative behavioral healthcare. Behavioral Innovations is seeking an experienced and detail-oriented RCM Specialist to support our Psychological Testing services.
About the Role:
As a RCM Specialist – Psychological Testing, you'll manage all aspects of the revenue cycle related to psychological testing services, including insurance verification, authorization, and claims management. This role plays a critical part in ensuring timely and accurate insurance benefit verification and financial clearance, directly impacting reimbursement and cash flow. The specialist will communicate with insurance carriers and clients using a resolution-driven approach grounded in payer guidelines, company policies, and thorough research. The position is accountable for the proper adjudication of third-party claims and is expected to follow established protocols and deadlines to maximize collections and reduce aging accounts receivable (A/R). Key responsibilities include timely follow-up and resolution of outstanding third-party balances, addressing payer denials, zero payments, submitting corrected claims, providing medical records, resolving posting errors, processing adjustments and write-offs, managing credit balances, and handling claim appeals. The specialist must also efficiently navigate payer and clearinghouse portals and manage payer correspondence to ensure clean claim resolution and sustained revenue cycle performance. If you thrive in a fast-paced environment and have strong follow-through skills, we want to hear from you.
What You’ll Do:
Verify insurance eligibility and benefits for psychological testing services and complete financial clearance processes.
Secure prior authorizations, submit required payer forms, and calculate patient financial responsibility accurately.
Track and document authorization approvals/denials in both CRM and EHR systems; communicate status updates to centers as needed.
Follow up on pending authorization requests and engage with payers to resolve delays or denials in a timely manner.
Identify trends in authorization denials, escalate issues, and recommend corrective actions or training needs for clinical staff.
Support clinical teams to ensure documentation meets payer requirements and facilitates clean claim submissions.
Review and evaluate claim payments to confirm reimbursement accuracy per payer guidelines and state fee schedules.
Conduct timely phone follow-ups with insurance carriers to ensure claim receipt, expedite reimbursement, and resolve issues.
Identify and resolve claim denials, rejections, and underpayments; resubmit corrected claims and appeals as necessary.
Investigate and reconcile overpayments, duplicate payments, and posting errors.
Coordinate with internal departments to obtain necessary information for claims resolution and timely payment.
Accurately process claim adjustments, write-offs, and credit balances according to company policy.
Submit secondary claims immediately upon receipt of primary payer remittance to avoid payment delays.
Ensure timely submission of medical records for medical necessity reviews and appeal processes.
Reduce outstanding third-party accounts receivable (A/R) and Days Sales Outstanding (DSO) aging through proactive follow-up.
Maintain detailed and consistent documentation of all payer communications in the EHR.
Adhere to HIPAA regulations and maintain confidentiality of all patient health information (PHI).
Stay current on insurance plan rules, billing procedures, government regulations, and medical terminology.
Ensure all collection activities follow company protocols and comply with Federal, State, and payer regulations.
Collaborate with internal teams to streamline workflows and support RCM goals.
Perform additional responsibilities as assigned by leadership.
Qualifications:
- Minimum 5 years of healthcare industry experience required.
- Minimum 5 years of medical Revenue Cycle collections experience required.
- Minimum 5 years of knowledge in a behavioral health or medical clinic setting preferred, but not necessary.
- Exhibit high quality work.
- Use excellent judgment.
- Communicate clearly.
- Takes initiative to identify and resolve issues.
- A willingness to learn and take on new tasks.
- Demonstrate resourcefulness, collaboration, and cooperation.
- Familiar with Electronic Medical Records and Billing Systems.
- Strong interpersonal and communication skills with an ability to collaborate effectively with teams, managers, and executive staff.
Why Behavioral Innovations?
- Comepnsation: Competitive Hourly Pay.
- Insurance: Medical, Vision, Dental, and Supplemental Insurance Policies.
- Daily Pay: Access your pay when you need it!
- Wellbeing Program: Equipping you with tools to achieve your wellness goals.
- Employee Assistance Program (EAP): Comprehensive support for your mental, emotional, and physical health.
- Supportive Team Structure: Our clients and families are our top priority, and we foster a collaborative and expert team environment.
- Additional Programs Offered at BI: Referral Bonuses, Employee Recognition, Employee Perks.
- Career Advancement Opportunities: Ongoing training & Professional development for all employees.
- University Partnerships: Enjoy tuition rate discounts.
- Meaningful work that supports children and families
Ready to make an impact with your RCM expertise?
APPLY TODAY and help us ensure every client gets the care they need—without billing barriers.
CORP2025
