Demo

RCM Specialist

Apollo Behavior
Suwanee, GA Full Time
POSTED ON 1/22/2025
AVAILABLE BEFORE 4/22/2025

Role : Revenue Cycle Management Specialist

Reports to : Julie Hernandez

Location : Remote, must be located in Georgia. You will occasionally come onsite to meet with Julie.

Schedule : Monday-Friday, 8 : 00 am - 5 : 00 pm

About Apollo Behavior :

Apollo Behavior is the premier provider of ABA therapy in metro Atlanta, and the largest ABA provider based in Georgia.

We are focused on being the best, and have heavily incorporated relational frame theory into our clinical model. Our excellence is not anecdotal - we have a ~25% annual client graduation rate, and many of our clients enter mainstream educational settings.

We embrace a servant leadership model and work hard every day to empower our team to do their best work and be their best selves. We are dedicated to ensuring that our team enjoys a fun, collaborative, non-bureaucratic culture and maintains a healthy work-life balance. To learn more, please visit our website at : https : / / www.apollobehavior.com /

Role : RCM Specialist

As a Revenue Cycle Management Specialist at Apollo Behavior, you will play a crucial role in ensuring the accuracy and efficiency of our revenue cycle management processes. Your responsibilities will include maintaining and updating authorization data in our systems, submitting timely authorization requests and appeals, and effectively communicating with the clinical team to gather necessary information. You will manage claims processing by following up on denied or unpaid claims, documenting the follow-up process, and auditing Central Reach data. Additionally, you will interact with families regarding patient responsibilities, identify and correct billing errors, and apply payments accurately in RCM software. Your proactive approach in contacting insurance for authorizations and benefits eligibility, coupled with your support in developing streamlined processes for the RCM team, will contribute to our commitment to compliance and optimal accounts receivable management.

Responsibilities :

Support efficient management of authorization workflows :

  • Support in maintaining accuracy of data in the authorization spreadsheet.
  • Submit accurate and timely authorization requests and appeals.
  • Maintain authorization data in RCM software
  • Communicate with clinical team as needed to obtain and share authorization information

Support efficient management of claims processing :

  • Follow up on denied or unpaid claims
  • Document claims follow up process
  • Accurately audit Central Reach data within weekly prescribed timelines.
  • Update Central Reach to reconcile accounts
  • Effectively communicate with families on patient responsibility.
  • Identify and correct errors in central reach billing data
  • Accurately apply payments in RCM software
  • Contact insurance to follow up on authorizations, benefits eligibility, and submitted claims
  • Generate and update spreadsheets with correct data as necessary.
  • Support RCM team in developing and maintaining efficient processes
  • Maintain compliant processes in all areas of revenue cycle management
  • Support the maintenance of payer portals
  • Accounts Receivables management
  • Read and understand billing reports and spreadsheets
  • This role might be for you if :

  • Strong attention to detail.
  • Effective problem-solving and troubleshooting.
  • Effective communication, both written and oral
  • Accurate data entry
  • Understanding of basic accounting principles of reconciliation and account balancing
  • Able to work with prescribed deadlines
  • Ability to effectively work within a team
  • Learn quickly and accept ongoing changes
  • Effectively perform routine and repetitive tasks
  • Understanding of workflows and systems
  • Independent and productive, without direct oversight
  • Able to work from home in a distraction-free environment
  • High speed, reliable Internet
  • Able to maintain HIPAA requirements while working from home
  • Basic math, including addition, subtraction, multiplication and division
  • Professional writing and communication
  • Be curious and ask questions
  • Benefits :

  • 24 paid days off per year (includes 14 paid holidays)
  • Health, life, vision, dental
  • 401(k) with a company match
  • Employee assistance program, including free mental health services, and discounts on everyday purchases
  • Student loan repayment assistance with employer match
  • Referral program
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