Revenue Integrity Specialist

Join the team! We are looking for a Behavioral Health Revenue Integrity Specialist to join ACME, an Assembly Health company. If you are looking for a company that is focused on being the best in the industry, love being challenged, and make a direct impact on our business, then look no further! We are adding to our motivated team that pride themselves on being client-focused, biased to action, improving together, and insistent on excellence and integrity.

This is a full-time, non-exempt position reporting to the Revenue Integrity Manager.

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What you'll do

• Accurately post payments and adjustments received from various commercial and third-party insurance companies.
• Maintain the EOB email inbox; reviewing various requests from credentialing, underpaid claims, medical records, denials and refunds. Sorting based on priority of client needs.
• Collaboration with billing specialists, account managers, clients, and other relevant parties to resolve and identify payment-related issues.
• Investigate the source of unidentified payments to ensure they are applied to appropriate accounts
• Interpret EOBs and ERAs.
• Handle all follow-up, research, and general responsibility of finding and identifying proposed negotiations via insurance portals, scans, faxes, and emails.
• Oversee the Negotiations inbox and provide timely resolution to requests.
• Manage and review contract negotiations between SCA/LOA’s.
• Notate and store all relevant negotiation information in Google Suite and companies billing systems.
• Assist in the timely resolution of client inquiries and requests.
• Collaboration with billing specialists, account managers, clients, and other relevant parties to resolve and identify payment-related issues.
• High-volume review and delegation of client communication and insurance correspondence.
• Achieve performance goals or objectives (individual or departmental) as established by the Manager.
• Maintain HIPAA and compliance standards to preserve patient confidentiality.
• Other tasks as needed.
  
  

What we're looking for

• 2-3 years of experience working in Payment Posting and Negotiations in the behavioral healthcare space.
• Strong problem-solving skills with analytical and critical thinking abilities.
• Minimum of one years’ experience using CollaborateMD, Availity, and Google Sheets.
• Knowledge of Third-Party Pricer’s to review trends/patterns.
• Proficiency in ICD-10, HCPCS/CPT, medical terminology, and levels of care.
• Superior written and verbal communication skills.
• Ability to manage critical deadlines with a self-motivated attitude and ability to multi-task.
• Must be resourceful, persistent, and an excellent problem solver.
• Ability to function well in a fast-paced and at times stressful environment.
• Prolonged periods of sitting at a desk and working at a computer. Ability to lift and carry items weighing up to 10 pounds at times.
  
  

Why join the team?

• Be part of something special! We are growing both organically and through acquisitions.
• Career growth - your next role with Assembly might not be created yet and we are waiting for your help to chart the way!
• Ongoing training and development programs
• An environment that values transparency
• Virtual and in-person events to connect with your team.
• Competitive Benefit Packages available, Paid Holidays, and Paid Time Off to enjoy your time away from the office.
  
  

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The compensation range for this position is $65,000 - $80,000 per year. Compensation for this role is based on a variety of factors, including but not limited to, skills, experience, qualifications, location, and applicable employment laws. The expected range for this position reflects these considerations and may vary accordingly. We also offer a comprehensive benefits package, including medical, dental, vision, 401(k), paid time off, and more.