Revenue Cycle Claims Specialist

 Posted 5 days ago
     
 $50000 - $60000 per year
  
2-5 years experience
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AI Summary

The Revenue Cycle Specialist manages the full insurance claims lifecycle, including eligibility verification, claim submission, and denial resolution. They also handle payment posting, reconciliation, and provide billing support to members while ensuring compliance with HIPAA standards.

Full-time, Remote | 9:00 AM – 5:30 PM CT, Monday–Friday


Position Overview

The Revenue Cycle Specialist is a critical role within NOCD’s Revenue Cycle Management

(RCM) team, responsible for managing the full insurance claims lifecycle—from eligibility

verification through payment posting and denial resolution. This role requires a strong foundation

in medical billing, insurance adjudication, and payer-specific guidelines, combined with a

commitment to providing an excellent member experience. You will work cross-functionally with

clinical, finance, and member support teams to ensure clean claim submission, timely

reimbursement, and accurate member billing.


Key Responsibilities

Insurance Verification & Eligibility

• Ability to verify member insurance eligibility and benefits prior to service, including

deductible, copay, coinsurance, and out-of-pocket maximums

Claims Submission & Management

• Submit clean claims electronically via EHR and clearinghouse platforms in compliance

with payer-specific requirements

• Ensure accurate coding of CPT, ICD-10, and modifier codes for behavioral health and

telehealth services

• Monitor claim status through payer portals and clearinghouses; identify and resolve

rejections prior to adjudication

• Manage claims across multiple payers


Denial Management & Appeals

• Review and work denial queues daily

• Draft and submit clinical and administrative appeals with supporting documentation

• Track appeal outcomes and escalate payer trends to leadership for contract and process

improvements


Payment Posting & Reconciliation

• Post insurance EOBs and ERAs accurately to patient accounts; reconcile payments

against expected reimbursements

• Identify and resolve underpayments, overpayments, and contractual adjustments in

accordance with payer contracts

• Process member refunds and balance transfers as appropriate


Member Billing & Support

• Respond to member billing inquiries via phone, email, and chat with accuracy and

empathy

• Explain EOBs, member responsibility amounts, and payment options clearly

• Resolve billing disputes, identify errors, and apply corrections with appropriate

documentation in the CRM and EHR


Reporting & Compliance

• Maintain accurate records of all claims activity, member interactions, and billing

adjustments

• Adhere to HIPAA guidelines and company compliance standards in all communications

and data handling

• Report KPIs including denial rates, days in A/R, clean claim rates, and collection rates to

manager on a regular cadence


Qualifications

Required

• 2+ years of experience in medical billing, revenue cycle, or insurance claims processing

• Working knowledge of the full claims lifecycle: eligibility verification, claims submission,

denial management, appeals, and payment posting

• Proficiency reading and interpreting Explanations of Benefits (EOBs) and Electronic

Remittance Advices (ERAs)

• Solid understanding of insurance terminology: deductible, copay, coinsurance, prior

authorization, coordination of benefits, and timely filing

• Experience with CPT and ICD-10 coding for behavioral health or telehealth services

• Familiarity with clearinghouse platforms and EHR systems

• Strong attention to detail, analytical thinking, and ability to manage high-volume work

queues

• Excellent written and verbal communication skills; ability to explain billing clearly to

members


Preferred

• Experience in behavioral health, mental health, or telehealth billing

• Familiarity with Medicaid and Medicare billing requirements

• Experience working denials and drafting payer appeals

• Bachelor’s degree in healthcare administration, business, or related field

• CPC, CPMA, or equivalent billing/coding certification

Note: Role responsibilities are subject to change based on business needs. A flexible, “floater” mentality

is valued on this team.

What We Offer

  • Comprehensive benefits package, including medical, dental, vision coverage, and 401(k) match
  • 11 observed company holidays a year
  • PTO based on an accrual system
  • Engaging startup environment with an outstanding mission-driven team atmosphere
  • Downtown Chicago office with an on-site gym
  • Noto provides 12 weeks of fully paid parental leave for the primary caregiver, and 6 weeks of fully paid leave for the secondary caregiver, for qualifying full-time employees.


Pay Transparency

The expected pay range for this position is $50,000 to $60,000. Actual pay will be based on the individual’s qualifications and experience. This role is also eligible for annual performance-based incentives tied to individual achievement and company-wide goals

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