Revenue Cycle Management (RCM) Specialist- Coding

Under the direction of the Director of Revenue Cycle Management, the Revenue Cycle Management (RCM) Specialist- Coding is responsible for the accurate, complete, and timely coding of behavioral health claims. This position involves coding claims for designated payers, auditing the work of other coders, and addressing coding related denials and rejections. The RCM Specialist- Coding must have an in-depth understanding of billing guidelines and compliance requirements for commercial insurance, Medicaid, and Medicare. Key Responsibilities: Behavioral Health Coding and Compliance: Assign appropriate ICD-10 and CPT/HCPCS codes to behavioral health claims, ensuring all coding is compliant and supported by clinical documentation. Auditing coded claims to verify accuracy and adherence to state and federal regulations, providing constructive feedback as necessary. Adhere to established coding guidelines and legal standards to maintain compliance with federal and state regulatory requirements. Act as a subject matter expert by responding to coding related inquiries and contributing to internal quality assurance efforts. Communicate with clinical staff to gather necessary information for accurate and complete coding. Offer feedback to department leadership on the quality of clinical documentation and recommend opportunities for improvement. Coding Related Denial and Rejection Management: Correct coding errors and resubmit denied and rejected claims in a timely manner to improve cash collections. Provide feedback and training to staff to prevent future coding-related denials.