Revenue Cycle Management Specialist

Background: 

FamilyWell Health is an AI-enabled mental health start-up dedicated to solving the women’s mental health crisis by seamlessly embedding high quality, equitable, & affordable mental health care into OB/Gyn practices. FamilyWell provides comprehensive virtual mental health services designed specifically for integration into OB/Gyn practices utilizing the psychiatric collaborative care model. FamilyWell’s virtual care team model delivers evidence-based coaching, therapy, care coordination, and psychiatric services with specialized expertise in perinatal mental health and perimenopause/menopause.

Job Title: Revenue Cycle Management Specialist 

Industry: Healthcare 

Location: Remote 

Seniority Level: Entry-Level 

Employment Type: W2, Full-Time 

About the Role: 

We are seeking a highly detail-oriented and motivated Revenue Cycle Management Specialist to join our healthcare team. This is a remote, entry-level position ideal for professionals with a strong foundation in insurance verification and medical billing, who are ready to contribute to a fast-paced and mission-driven environment. You will be responsible for ensuring timely and accurate claims processing and payment collections to support the financial operations of the organization. 

Key Responsibilities: 

• Perform insurance verification for patients, ensuring coverage accuracy and completeness.
• Follow up on unresolved insurance claims to secure timely payment. 
• Make phone calls and utilize insurance portals to check claim statuses and resolve issues. 
• Update plan IDs, correct payor or patient demographic and insurance information, and document actions taken in detailed account notes. 
• Identify payor issues, trends, and re-coup problems; take action to resolve them efficiently.
• Request additional documentation (e.g., medical records, patient information) to support claims as needed. 
• Follow up on patient balances as assigned. 
• Collaborate with team members to ensure smooth revenue cycle operations.
• Maintain a high level of accuracy and organization in managing patient insurance records. 
• Distraction free environment. 
• Maintain PHI compliance. 
• Other administrative and billing tasks as assigned.

Billing and Invoicing/Claims

• Ensure invoices and claims are properly documented, approved, and sent on schedule.
• Generate accurate and timely invoices for clients and partners. 
• Provide member/insurance revenue management support throughout the revenue cycle, to include but not limited to: Claims Management, Accounts Receivable, Payment Posting and Denials Management 

Financial Recordkeeping 

• Collaborate on reconciling accounts and resolving discrepancies. 

Denial Management 

• Timely follow up with health plan partners on outstanding claims 
• Submission of corrected claims and appeals as applicable. 

Collections

• Generate member statements and work with members to collect and resolve past due balances. 

Reporting and Analysis 

• Assist in generating regular reports on payment status and financial performance.
• Analyze data to identify trends and areas for improvement. 

Compliance and Documentation 

• Ensure adherence to financial regulations and policies. 
• Maintain accurate documentation of payment processes. 

Customer Success 

• Provide empathetic and compassionate customer service to families who may be struggling to meet payment obligations. 
• Resolve payment disputes or concerns professionally and courteously. 
• Maintain open communication with providers, payers, and internal stakeholders to resolve insurance eligibility and benefits, as well as claims issues. 

Qualifications:

• High school diploma or equivalent required
• Minimum of 2 years of experience in a medical billing, insurance verification, or healthcare office environment. 
• Knowledge of insurance coverage types, policies, and claims processes.
• Medical billing certification is a plus.
• Proficiency in Google suite, Microsoft Office and prior computer experience required.
•  Experience using EMR/EHR systems and insurance portals.
• Strong multitasking, organizational, and time-management skills. 
• Excellent verbal communication and documentation skills. 
• Ability to analyze trends, identify root causes, and solve problems independently.
• Comfortable working remotely and independently with minimal supervision. 
• 2+ years of experience as a revenue cycle specialist, payment coordinator, accounts receivable specialist, or a similar role required. 
• 1+ years of behavioral health billing experience required. 
• Excellent attention to detail and accuracy in data. 
• Strong understanding of billing and invoicing processes. 
• Highly independent, proactive, resilient, and empathetic. 

Perks & Benefits: 

• Health insurance 
• Paid time off (PTO) 
• Opportunities for growth and continued learning