Revenue Cycle Specialist

Company Overview
Clearwave Mental Health is dedicated to providing compassionate, personalized, and innovative mental health treatment to our community. Led by experienced medical professionals, we are committed to advancing mental health care through cutting-edge therapies and comprehensive services.

Job Summary
We are seeking a motivated and detail-oriented Revenue Cycle Specialist to join our dynamic team. In this vital role, you will manage the full revenue cycle, from insurance verification and claims submission through payment posting, denials management, and patient billing support. This is an in-person, full-time role in Poughkeepsie, NY.

Responsibilities

• Manage the end-to-end revenue cycle: verify insurance coverage, submit claims, track status, resolve denials, and follow up for payment.
• Process insurance claims accurately and efficiently through our billing system.
• Post insurance payments, reconcile accounts, and monitor outstanding balances.
• Contact insurance companies to resolve claim issues, including managed Medicaid plans, prior authorizations, and behavioral health claim nuances.
• Collaborate with providers and front office teams to support specialized services, such as TMS and Spravato treatments.
• Communicate professionally with patients regarding balances and billing questions.
• Ensure all patient information is secure and that all communications and disclosures are HIPAA compliant.
• Perform any other tasks or responsibilities as needed and communicated by the Executive Team.

Requirements

• Proven experience in medical billing, coding, or revenue cycle management within a healthcare setting.
• Demonstrated experience with complex denials, appeals, and payer follow-up.
• Familiarity with major commercial payers (BCBS, United Healthcare, Aetna, etc.) and Medicaid/Medicare plans.
• Proficiency with EHR/EMR systems and billing platforms.
• Knowledge of CPT/HCPCS and ICD-10 coding standards.
• Strong communication skills for interacting with patients, providers, and insurance representatives.
• Detail-oriented, organized, and able to manage multiple claims efficiently.
• Prior experience in mental health or behavioral health settings is a plus.

Preferred:

• Associate or bachelor’s degree in health administration, accounting, or related field.
• Hands-on medical billing/claims management experience, preferably in mental health or outpatient care.

Join us as a Revenue Cycle Specialist and be a key player in delivering quality mental health services while ensuring our financial operations run smoothly!

Pay: From $23.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off

Work Location: In person