Role overview

Qualifications

High School diploma or equivalent, college preferred
A minimum of 3-5 years of experience in healthcare billing/accounts receivable/revenue cycle
Experience in Forward Health in Wisconsin preferred
Proficient in CPT, ICD10, HCPCS coding, and Microsoft Suites

Responsibilities

Manage the complete revenue cycle for assigned Wisconsin payors, including accurate claim submission, payment posting review, denial resolution, appeals, and follow-up.
Investigate and resolve claim denials, rejections, and payment discrepancies by collaborating with internal departments and payor representatives.
Generate invoices for private payers, county payers, and state billing programs.
Monitor changes to Wisconsin Medicaid and commercial payor policies, proactively communicating updates and recommending workflow improvements.

Key facts

Remote from: Wisconsin (USA)
Full time
Conference Coordinator
English

Hard skills

CPT Coding ICD Coding (ICD-9/ICD-10) Medical Billing Accounts Receivable Medicaid Online Communication

Other skills

Microsoft Excel
Microsoft Word
Microsoft Outlook
Detail Oriented
Customer Service
Non-Verbal Communication
Problem Solving
Multitasking
Adaptability

About the company

LEARN Behavioral

Special Education & Disability Services

We’re a national organization made up of some of the most established providers of autism treatment. Our purpose: nurturing the potential of children and young adults with autism and special needs—and empowering kids and families to lead happy, fulfilling lives. We specialize in using contemporary, evidence-based applied behavior analysis (ABA) to tailor treatment exclusively to the needs and values of every child and family in our care. Our local and national clinicians arrive at work each day equipped with the latest research, the most extensive support and professional development, and clinical insights from one of the largest and most diverse behavioral health data sets in the country, amassed from treating more than 25,000 children over two decades. Our ability to derive insights from each child’s data, in addition to the aggregated data we’ve accumulated over time and across the country, gives us what we need to make evidence-based treatment decisions—and ultimately deliver personalized, effective care. With more than 30 doctoral-level clinicians, 500 behavior analysts, and 4,500 behavior technicians, our organization treats more than 5,000 children across 19 states and the District of Columbia. Our providers include Autism Spectrum Therapies (AST), Total Spectrum, the Wisconsin Early Autism Project (WEAP), Behavioral Concepts (BCI), Trellis, SPARKS, the Behavior Analysis Center for Autism (BACA), Priorities ABA, Tandem Therapy Services, and UP Autism Center. To find out more, visit us online—and view our job openings (we’re growing!).

Company details

Company typeLarge

IndustrySpecial Education & Disability Services

Company size1001 - 5000

Links

Website LinkedIn See all jobs

Your match analysis

See how your profile stacks up against this role.

We compared the job requirements to your profile to show where you're strong and where you fall short.

Job description

Overview:

LEARN Behavioral is a national organization made up of dedicated and caring individuals with the sole purpose of nurturing children with autism and special needs to lead resilient and fulfilling lives. We specialize in contemporary, evidence based applied behavior analysis to deliver personalized treatment plans, backed by 20 years of clinical insights. We are proud to be a part of each family’s journey and share in the experience of finding success for every child, and family, in our care. If you share a similar passion for nurturing and empowering the success of others, along with the opportunity to have an impact on the lives of others, we are eager to connect with you!

The Revenue Cycle Management (RCM) Coordinator works under the guidance of the RCM Specialist/RCM Manager to support revenue cycle operations. The ideal candidate will demonstrate exceptional attention to detail, uphold the highest standards of customer service, possess outstanding written and verbal communication skills, and exhibit proficiency in revenue cycle management processes and practices.

This is a full-time remote opportunity. Open to candidates who reside in any time zone. Pay starting at $24/hr.

Responsibilities:

Manage the complete revenue cycle for assigned Wisconsin payors, including accurate claim submission, payment posting review, denial resolution, appeals, and follow-up to maximize reimbursement and reduce accounts receivable.
Investigate and resolve claim denials, rejections, and payment discrepancies by working collaboratively with internal departments and payor representatives to identify root causes and implement corrective actions.
Generate invoices for private payers, county payers, and state billing programs.
Follow up on assigned outstanding aging reports to ensure prompt remittance.
Monitor changes to Wisconsin Medicaid and commercial payor policies, fee schedules, and billing requirements, proactively communicating updates and recommending workflow improvements to maintain compliance and optimize reimbursement.
Partner with Clinical Operations, Utilization Management, Credentialing, and other cross-functional teams to resolve billing issues, improve revenue cycle performance, and support timely, accurate reimbursement for ABA services.
Support the maintenance and achievement of departmental KPIs.
Prepare weekly accounts receivable (AR) reports covering claim submission, billing, follow-up, and analysis.
Identify and communicate potential revenue risks and opportunities.
Comply with all company billing policies, procedures, and regulatory compliance standards.
Perform special projects and additional tasks as assigned.

Qualifications:

High School diploma or equivalent, college preferred
A minimum of 3-5 years of experience in healthcare billing/accounts receivable/revenue cycle
Experience in Forward Health in Wisconsin (i.e., Wisconsin Medicaid) preferred
Proficient in CPT, ICD10, HCPCS coding, and Microsoft Suites (Excel, Word, and Outlook)
Communicates well via written and verbal methods
Customer/client relationship focused
General knowledge of EDI reports
Analytical with strong problem-solving abilities
Ability to multi-task and maintain thoroughness
Thrive in a fast-paced environment
Adaptable to change
Positive approach to daily routine

LEARN Behavioral offers competitive compensation, a comprehensive benefits plan, including 401(k), personal time off, paid holidays, and tuition reimbursement.

LEARN Behavioral is an Equal Opportunity Employer. Candidates must be presently eligible to work in the United States.