Revenue Recovery Specialist (MH/SUD)

About Us

At Core Billing Services, our mission is simple: ensure providers are properly reimbursed so they can continue delivering life-saving mental health and substance use disorder care.

Every claim we recover, every underpayment we correct, and every issue we escalate directly impacts a patient’s ability to access care. We are a team that believes in accountability, persistence, and turning over every rock to do what is right for our clients and the communities they serve.

About the Role

We are seeking an experienced Revenue Recovery Specialist who takes ownership of outcomes and understands the importance of accurate reimbursement in behavioral health.

This role is responsible for auditing paid claims, identifying discrepancies, and driving reprocessing efforts for Mental Health (MH) and Substance Use Disorder (SUD) services. You will play a key role in ensuring payers and TPAs uphold their financial obligations.

Key Responsibilities

• Audit paid claims to identify underpayments, inconsistent payments, and incorrect adjudication
• Review and manage claims within our billing software (CMD)
• Initiate and track reprocessing requests with payers
• Complete post-payment inquiries with TPAs including Data iSight, Viant, Global Claims Services, and Multiplan
• Identify trends and escalate systemic reimbursement issues
• Maintain detailed documentation and follow-through on all claims
• Collaborate with internal teams to ensure reimbursement accuracy

Requirements

• Minimum 2+ years of experience in revenue recovery, post-payment review, or underpayment resolution
• Behavioral health billing (MH/SUD required)
• Proven experience auditing paid claims and driving reprocessing
• Experience working with TPAs such as Viant and/or GCS
• Strong understanding of payer reimbursement methodologies
• Ability to work independently and take initiative in a remote setting

Preferred Qualifications

• Experience using CMD
• Experience with PHP and IOP billing
• Familiarity with in-network and out-of-network workflows

What We’re Looking For

• Someone who is relentless in resolving claims
• Highly detail-oriented and analytical
• A problem-solver who does not accept incomplete answers
• Someone who understands that this work directly supports patient care

Job Type: Full-time

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday
• No weekends

Work Location: Remote

Job Type: Full-time

Pay: From $55,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Application Question(s):

• How many years of experience do you have with CMD?
• Do you have AR experience in MH and SUD? If so, how many?
• Do you have experience with third party pricing companies? If so, which ones?
• How many years of behavioral health payment auditing do you have?

Work Location: Remote