Perimeter Healthcare - Integrated Behavioral Health

Revenue Cycle Specialist

• Submits monthly claims and invoices along with discharge claims within two business days of creation.
• Reviews Payor Aging and works accounts accordingly for multiple sites within a Central Business Office Environment.
• Ensures accurate, complete, and timely account follow-up. Documents accounts within Perimeter guidelines.
• Resolves claim processing issues in a timely manner, escalates problem claims to their supervisor.
• Resolves credit balances in a timely manner.
• Reviews Remittance Advices daily and prioritizes Zero Pay accounts for immediate resolution.
• Works directly with Payor Plans/Funding Sources to resolve ongoing issues.
• Communicates Payor updates to Revenue Cycle Leadership in a timely manner.
• Reviews Facility Correspondence in a timely manner.
• Reviews new Admissions for Payor Plan accuracy.
• Prepares write-off requests based on review of balances, and submits to leadership for review and approval
• Reviews Denial Log and coordinates Denial write-offs with Facility UM Director.
• Familiar with billing requirements for payor plans...not limited to Medicaid and Medicare.

General

• Overseeing multi-state placement navigation across all programs, ensuring referrals are matched to the most clinically appropriate and feasible site.
• Conduct comprehensive clinical screenings using established criteria, considering behavioral, medical, neurodevelopmental, and acuity-based needs.
• Collaborates with corporate leadership to develop and refine system-wide placement protocols, referral algorithms, and decision-making matrixes.
• Track, analyze, and report on referral trends, acceptance rates, denials, and barriers to placement.
• This position serves as a centralized point of contact for complex referrals requiring cross-facility collaboration or escalated decision-making.

Revenue Cycle Specialist

Admissions Coordinator