RCM Billing Specialist
Osmind
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United States
Key Responsibilities
- Review insurance claim prior to filing for accuracy and completeness
- Review medical documentation to ensure that all charges are captured and coded correctly
- Work clearinghouse rejections ensuring that claims are filed in a timely manner
- Provide expert guidance on mental health billing, with a specific focus on complex treatments like TMS and Spravato
- Analyze, document and escalate to resolve complex billing issues, denials, and appeals in partnership with our billing partners
- Develop and maintain relationships with key stakeholders including clinic owners, practice managers, and billing company leadership
- Become the internal Subject Matter Expert on our billing software. Contribute to the development and refinement of our billing services, working closely with our product and operations teams
- Stay up-to-date on industry trends, regulatory changes, and payer policies that impact mental health billing serving as an expert for internal resources
Required Qualifications
- 3+ years of experience in healthcare revenue cycle management, with at least 2 years specifically in mental health or behavioral health billing
- Deep understanding of CPT coding, insurance claim processing, and payer reimbursement models
- Demonstrated expertise in billing for TMS, Spravato, and other interventional psychiatric treatments
- Excellent communication and interpersonal skills, with the ability to explain complex billing concepts to both clinical and non-clinical staff
- Proficiency in electronic health record (EHR) systems and practice management software
Preferred Qualifications
- Experience working in or consulting for an MSO or large psychiatric practice group
- Familiarity with value-based care models and alternative payment structures in mental health
- Knowledge of healthcare compliance regulations (e.g., HIPAA, Stark Law)
- Experience with data analytics tools and generating actionable insights from RCM data
A Successful First Year Might Look Like...
- Onboarding and optimizing RCM processes for multiple psychiatric clinics, resulting in an improvement in collection rates
- Developing and implementing best practices for TMS and Spravato billing that reduce denial rates
This job is no longer accepting applications
See open jobs at Osmind.See open jobs similar to "RCM Billing Specialist" General Catalyst.