Signet Health is currently seeking an experienced person for our full-time Revenue Cycle Specialist of Behavioral Health Service Line with our program in Washington DC. 

Position Summary

The Revenue Cycle Specialist supports accurate and timely billing, charge entry, denial management, and reimbursement activities for behavioral health services, including Partial Hospitalization (PHP), Intensive Outpatient Programs (IOP), general outpatient services, and inpatient admissions. This role plays a critical part in ensuring clean claim submission, payer compliance, accurate authorization workflows, and resolution of billing discrepancies.

This role collaborates closely with clinical, registration, scheduling, and revenue cycle teams to promote accurate charge capture, reduce denials, and support the department's overall financial performance and compliance goals.

Key Responsibilities

Billing, Charge Capture & Claims Processing

• Review and validate clinical documentation, charges, and coding for completeness and accuracy.
• Submit timely and accurate claims (electronic and paper) in accordance with payer requirements.
• Ensure CPT, ICD-10, HCPCS, and revenue codes are correctly applied.
• Maintain real-time updates to billing and authorization trackers for PHP, IOP, and outpatient services.
• Monitor and resolve missing charges or discrepancies to prevent revenue leakage.

Denials, Appeals & Reimbursement

• Identify and resolve billing rejections and denials through timely follow-up and resubmission.
• Draft appeal letters and collaborate with clinical staff to gather supporting documentation.
• Assist with payer inquiries, authorization-related discrepancies, and underpayment trends.
• Escalate unresolved issues with payer representatives or vendors as needed.

Authorizations & Workflow Support

• Complete and assist in acquiring and verifying authorization and reauthorization status for all behavioral health levels of care.
• Update authorization spreadsheets and ensure all required information is documented for claims.
• Partner with scheduling and registration to prevent front-end delays that impact reimbursement.

Metrics, Reporting & Process Support

• Support Director with data collection and reporting on key revenue cycle indicators.
• Generate routine reports for charge reconciliation, denials, and claim status follow-up.
• Contribute to continuous improvement initiatives by identifying workflow gaps or inefficiencies.
• Participate in team meetings and trainings to maintain up-to-date knowledge of payer changes, workflows, and revenue cycle procedures.

Required Qualifications

• Minimum of 3 years of billing, coding, or reimbursement experience in a healthcare setting; behavioral health preferred.
• Strong knowledge of CPT, ICD-10, HCPCS, and behavioral health billing rules.
• Demonstrated understanding of the end-to-end revenue cycle process, including authorization and denial management.
• Certified Professional Coder (CPC) or Certified Revenue Cycle Representative (CRCR) preferred.
• Experience with payers in the DMV region, including Medicaid (DC, MD, VA), Medicare, and commercial insurers.
• Proficiency in EHR and billing software (e.g., Epic, MedConnect, Medhost, or similar) and Excel.
• Strong communication, organization, and problem-solving skills.
• Bachelor’s degree preferred; equivalent experience accepted.

EOE

Salary Information:

Minimum:  $70,000 annually

Maximum: $84,700 annually

Depending on Experience