Full-time, Remote | 9:00 AM – 5:30 PM CT, Monday–Friday
Position Overview
The Revenue Cycle Specialist is a critical role within NOCD’s Revenue Cycle Management
(RCM) team, responsible for managing the full insurance claims lifecycle—from eligibility
verification through payment posting and denial resolution. This role requires a strong foundation
in medical billing, insurance adjudication, and payer-specific guidelines, combined with a
commitment to providing an excellent member experience. You will work cross-functionally with
clinical, finance, and member support teams to ensure clean claim submission, timely
reimbursement, and accurate member billing.
Key Responsibilities
Insurance Verification & Eligibility
• Ability to verify member insurance eligibility and benefits prior to service, including
deductible, copay, coinsurance, and out-of-pocket maximums
Claims Submission & Management
• Submit clean claims electronically via EHR and clearinghouse platforms in compliance
with payer-specific requirements
• Ensure accurate coding of CPT, ICD-10, and modifier codes for behavioral health and
telehealth services
• Monitor claim status through payer portals and clearinghouses; identify and resolve
rejections prior to adjudication
• Manage claims across multiple payers
Denial Management & Appeals
• Review and work denial queues daily
• Draft and submit clinical and administrative appeals with supporting documentation
• Track appeal outcomes and escalate payer trends to leadership for contract and process
improvements
Payment Posting & Reconciliation
• Post insurance EOBs and ERAs accurately to patient accounts; reconcile payments
against expected reimbursements
• Identify and resolve underpayments, overpayments, and contractual adjustments in
accordance with payer contracts
• Process member refunds and balance transfers as appropriate
Member Billing & Support
• Respond to member billing inquiries via phone, email, and chat with accuracy and
empathy
• Explain EOBs, member responsibility amounts, and payment options clearly
• Resolve billing disputes, identify errors, and apply corrections with appropriate
documentation in the CRM and EHR
Reporting & Compliance
• Maintain accurate records of all claims activity, member interactions, and billing
adjustments
• Adhere to HIPAA guidelines and company compliance standards in all communications
and data handling
• Report KPIs including denial rates, days in A/R, clean claim rates, and collection rates to
manager on a regular cadence
Qualifications
Required
• 2+ years of experience in medical billing, revenue cycle, or insurance claims processing
• Working knowledge of the full claims lifecycle: eligibility verification, claims submission,
denial management, appeals, and payment posting
• Proficiency reading and interpreting Explanations of Benefits (EOBs) and Electronic
Remittance Advices (ERAs)
• Solid understanding of insurance terminology: deductible, copay, coinsurance, prior
authorization, coordination of benefits, and timely filing
• Experience with CPT and ICD-10 coding for behavioral health or telehealth services
• Familiarity with clearinghouse platforms and EHR systems
• Strong attention to detail, analytical thinking, and ability to manage high-volume work
queues
• Excellent written and verbal communication skills; ability to explain billing clearly to
members
Preferred
• Experience in behavioral health, mental health, or telehealth billing
• Familiarity with Medicaid and Medicare billing requirements
• Experience working denials and drafting payer appeals
• Bachelor’s degree in healthcare administration, business, or related field
• CPC, CPMA, or equivalent billing/coding certification
Note: Role responsibilities are subject to change based on business needs. A flexible, “floater” mentality
is valued on this team.
What We Offer
Pay Transparency
The expected pay range for this position is $50,000 to $60,000. Actual pay will be based on the individual’s qualifications and experience. This role is also eligible for annual performance-based incentives tied to individual achievement and company-wide goals