ReKlame Health · 13 hours ago
Coding & RCM Specialist
United States
Full-time
Remote
Mid Level
$60K/yr - $85K/yr
3+ years expReKlame Health is a clinician-led, tech-enabled provider group focused on expanding access to behavioral health and addiction care. The Coding & RCM Specialist will support accurate coding and clean claims submission in a complex Medicaid and managed-care environment, ensuring compliance and improving claim quality through detailed documentation and collaboration with various teams.
HealthcareHealth Care
Responsibilities
Own CPT/ICD-10 coding and strategy across psychiatry and medication management, with a focus on high-acuity and complex patient populations
Review clinical documentation (eg SOAP notes) and supporting information to ensure clean claim submission
Improve first-pass claim acceptance by proactively ensuring correct coding, flagging inconsistencies, and documenting gaps for correction
Perform pre-bill and post-pay audits on a rolling basis
Review EOBs and denial trends to identify recurring coding issues
Document audit findings using structured templates and tracking tools
Flag systemic risks to improve the process and escalate high-risk patterns or unusual payer behavior when necessary
Work closely with billing team members, senior management, and vendors to resolve claim issues
Support coding corrections and resubmissions, provide clarification, and maintain internal reference guides for other team members when necessary
Ensure compliance and alignment with CMS, state Medicaid, and managed-care guidelines
Monitor changes in payer policies and stay up to date on behavioral health and psychiatry guidelines
Partner with the credentialing and billing teams on implementing new payer contracts and RCM workflows
Qualification
Required
Minimum of 3-5 years of professional experience in medical coding and billing required
Certified Professional Coder (CPC) or Certified Coding Specialist (CCS)
Advanced proficiency with ICD-10, CPT, and HCPCS coding systems
Experience working with EHR systems, clinical notes, and medical billing software required
Exceptional accuracy and attention to detail in coding/billing and documentation
Strong understanding of HIPAA and healthcare compliance guidelines, with the ability to adapt to changing regulations
Analytical mindset with the ability to address complex challenges, identify solutions, and implement improvements with speed and accuracy
Preferred
Experience working with RCM and billing vendors is a strong plus
Strong preference for candidates with experience in behavioral health coding and expertise in Medicaid and managed-care systems
Experience with denial resolutions, coding audits, and QA review preferred
Benefits
Full Health Benefits: Medical, dental, and vision
Paid Time Off (PTO): 21 days of paid time off, including vacation and sick leave.
Professional Development: Unlock growth opportunities within a purpose-driven early-stage organization dedicated to creating a positive impact.
Company
ReKlame Health
A culturally-diverse telepsychiatry practice providing high-quality, affordable treatment to young & BIPOC individuals.
11-50 employees
Funding
Current Stage
Early StageLeadership Team
Evans Rochaste, NP
Founder|CEO
Recent News
2023-04-12
2023-03-10
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