Responsibilities
Full claims lifecycle for outpatient behavioral health services across commercial, Medicare, and Medicaid managed care payers
Denials management: root-cause analysis, appeals, resubmissions, payer follow-up, and prevention
AR aging triage, payer follow-up strategy, and escalation of recurring issues
ERA/EOB posting and reconciliation against expected contracted rates
Investigation of underpayments, rate anomalies, ERA disruptions, and recurring denial patterns
Written proc