Revenue Cycle Specialist III

Who We Are At ERC Pathlight, we're on a mission to change lives—and we're looking for people who feel called to do the same. As one of the nation's leading treatment providers for eating disorders and mood, anxiety, and trauma-related conditions, we bring innovative, evidence-based, and deeply compassionate care to patients across the country. With multiple locations nationwide and extensive virtual programming, we meet patients exactly where they are and help them move toward lasting recovery. Founded in 2008 by renowned psychiatrists and psychologists, ERC Pathlight now supports more than 6,000 patients each year. And as the need for world-class mental health care continues to rise, our commitment is stronger than ever: to expand access, elevate the standard of care, and empower every patient to rebuild their life with dignity and hope. Why Join Us When you join ERC Pathlight, you become part of a team that shows up every day to make a real difference. You'll work alongside passionate clinicians, dedicated support staff, and mission-driven leaders who believe in collaboration, growth, and doing the right thing—always. Here, your work matters. Your ideas matter. You matter. If you're energized by purpose, motivated by impact, and ready to help transform the future of mental health treatment, you belong here. Come build hope. Come save lives. Come grow with us. What you'll be doing The Revenue Cycle Specialist III (RCS-III) is responsible for working closely with the Supervisor and the RCS Manager to ensure that Business operations are working correctly and efficiently. The RCS-III is responsible for assisting insurance claims management by running Practice Management reports and reporting the finding to the supervisor and RCS Manager. The RCS-III must be committed to consistently modeling ERC Pathlight's core values and ensuring a positive, results-oriented, and reliable customer experience. The Revenue Cycle Specialist III is responsible for denial management functions for the revenue cycle department by monitoring and reporting on payor denial and slow-pay trends and conducting root-cause analysis. This position will interact and meet with teammates within the department who require assistance in effectively problem solving a specific account level denial, manage a set of assigned escalated accounts, and partner with department leadership and SMEs to develop and maintain denials management training and guidelines. This position requires both strong critical thinking and communication skills and will partner with management and teammates in Revenue Cycle, Patient Access, Utilization Review, Medical Records, Training & Process Optimization and Business Analysts teams.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Analysis Analysis completed regularly utilizing available application systems (ex. Practice Management (PM), Electronic Data Interchange (EDI), Data Warehouse) to identify denied payor trends and patterns. Root-cause analysis related to identified trends or specific escalated accounts and delivering recommendations for any necessary education and or process change(s) and share findings with leadership stakeholders. Accounts Receivable Insurance Claims Follow-up Accountable for monitoring and resolution of specific accounts in delayed/open/unpaid status as assigned by leadership. Call/Email Insurance Payors to resolve unpaid delayed/open/unpaid claims. Navigating Insurance Payor portals to resolve unpaid claims. Using denials management software (EDI), Updates and maintains denials trending reports for distribution to users Process Medical Records Requests when needed. Process requests for claim adjudication or additional adjustments when needed. Collaboration Collaborate with teammates as needed to provide advice, consultation, observation, and training regarding claims management process, process changes and identified best practices (e.g. EDI utilization and optimization). As appropriate, attend available payor webinars and trainings, monthly monitoring of payor websites/listservs for applicable notices, newsletters or process change notifications. Share learnings with teammates. Customer Service Answer phone calls from insurance companies in the queue. Assist other departments with patient concerns/questions when needed. Systems Maintenance Submit Practice Management edits to Revenue Integrity Team & Data Business Analysts. EDI troubleshooting/User Support Help Onboard and train new teammates and support any knowledge transfer as needed Other duties as assigned

Required Qualifications:

High School or GED 3-5 years of healthcare revenue cycle experience 2- 3 years' working knowledge of Medical EHR and Practice Management software Minimum of 2 years' computer experience working with Microsoft Office Problem solving and Conflict Management Skills Excellent organizational, planning, and decision-making skills. Pays attention to detail, and ability to prioritize Demonstrated ability to deliver assignments within a deadline

Preferred Qualifications:

3-5 yrs behavioral health, commercial and government payor revenue cycle experience

Location & Schedule:

This position is posted as remote, but Denver, CO applicants are preferred and will be prioritized for interviews. In alignment with company policy, candidates who reside within a 35-mile radius of ZIP code 80230 will be expected to work a hybrid schedule:

Remote:

Mondays and Fridays On-site:

Tuesdays, Wednesdays, and Thursdays The compensation range for this position is based upon candidate experience and market expectations. Colorado pay range $27 - $32 USD What We Offer At ERC Pathlight, caring for people is our mission and that begins with caring for our own team. Your well-being matters, and our benefit program is designed to support every part of your life. We offer competitive compensation; comprehensive medical, dental, and vision coverage; generous Paid Time Off; Parental Leave benefits; Retirement benefits; and tuition reimbursement to help you continue growing in your career. We also recognize that mental health is part of every person's experience. That's why we strive to create a workplace where you feel supported, seen, and encouraged—personally, professionally, and at home. When you thrive, you can do your best work. And your best work changes lives.