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Revenue Cycle Specialist II

Job Description
Rocky Mountain Human Services
Organization Type: 
Job Location: 
Denver Metro
Type of Job: 
Job Category: 
Job Description: 

The Billing and Receivable Specialist works with different programs within RMHS and revenue cycle department in order to consistently submit claims to insurance payers and to ensure that they are paid as per contract terms. This position is also responsible for communication with internal and external customers and health service providers.

Why work at Rocky Mountain Human Services?

You will have the opportunity to contribute to an organization serving children with developmental delays and disabilities, adults with cognitive and intellectual disabilities, and veterans in need of employment assistance or who are homeless.



Areas of Responsibility

Essential Duties

  • Performs insurance verifications, prior authorizations and re-authorizations as required by funding source
  • Responsible for submitting claims and ensuring follow up on outstanding claims
  • Ensures information obtained is complete and accurate to request appropriate authorizations
  • Collaborates with internal departments and external providers on utilization management of authorizations
  • Acquires and shares knowledge of authorization requirements for all funding sources for behavioral health in the State of Colorado (commercial and waiver)
  • Ensures all services have authorizations properly documented in all software applications necessary and communicated to all programs within RMHS
  • Ensures up-to-date documentation in billing software
  • Ensures compliance with all federal, state, local and internal policies and procedures
  • Performs other duties as assigned with a comprehensive understanding of all functions on the entire revenue cycle

Knowledge, Skills and Abilities

  • Knowledge of healthcare billing and reimbursement strategies.
  • Ability to effectively communicate both orally and in writing.
  • Demonstrates the ability to plan and organize work, coordinate with others, use time productively and establish appropriate priorities.
  • Provide excellent customer service to both internal and external customers.
  • Attention to detail is a must for researching and interpretation.
  • Ability to support HIPAA privacy rules and maintain strict confidentiality.
  • Ability to function as a team player.
  • Ability to adapt to change and be flexible.

Preferred Qualifications

  • Previous experience working with healthcare insurance, billing (therapy services, behavioral health, Medicaid HCBS Waiver, Early Intervention), medical coding, denial management, and insurance reimbursement.
  • Experience with medical billing software.
  • Excellent communication skills (written, verbal).
  • Excellent customer service skills.
  • 1-2 yrs of relevant experience in finance/healthcare, medical billing & reimbursement.
  • Experience with State and Federal (Medicare, Medicaid) and private insurance billing systems.
  • Proficiency in Microsoft products including Word and Excel.

RMHS provides great benefits such as:

  • Employer paid medical, dental, and vision benefits
  • Generous paid time off such as vacation, sick, personal, and holidays
  • Life and disability insurance
  • Tuition reimbursement (full-time employees only)
  • Mileage reimbursement
  • 403(B) with company match
  • Employee assistance program
How To Apply

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