Senior RCM Billing Specialist

$30.07 - 34.58 /Hr.
Schedule: Monday - Friday; 8:00 am - 4:30 pm (Flexible schedule possible)
Hybrid: 3 days in-office; 2 days remote
Location: Skokie, IL

The Senior RCM Billing Specialist is responsible for timely and accurate submission of claims to payers, ensuring compliance with state, federal, and payer-specific requirements under both Fee-for-Service (FFS) and CCBHC billing models, as well as commercial payers.

This role prepares and submits claims, works edits, follows up on rejections, and ensures Trilogy’s billing processes run efficiently.

The Senior RCM Billing Specialist collaborates with authorization, credentialing, collections, and revenue integrity staff to ensure claims are submitted cleanly and payments are not delayed.

Essential Responsibilities


* Audit claims, charge capture, and billing workflows for accuracy and compliance.


* Review all behavioral health billing manuals and provider manuals regularly; communicate updates to leadership.


* Collaborate with clinical staff to ensure documentation supports billing requirements; provide education when needed.


* Monitor rejection trends, escalate systemic issues, and recommend solutions.


* Partner with Billing & Collections Supervisor and Network Administrator to ensure EMR fee schedules and codes are current.


* Ensure all new payer billing processes are correctly configured and tested in the clearinghouse prior to claim submission.


* Support payer audits, compliance reviews, and special projects.


* Attend payer webinars, provider calls, and training sessions to stay up to date on policy changes, billing requirements, and compliance updates; communicate updates to leadership


* Develop recommendations for reducing rejections and denials to improve revenue capture.


* Maintain and update documentation of billing workflows.


* Perform other duties and projects as assigned.

Qualifications


* Bachelor’s degree in Finance, Psychology, Social Work, Counseling, Behavioral Health, or other closely related field highly preferred


* Minimum 7 years of experience in the healthcare industry (particularly Medicaid and Managed Medicaid insurance companies)


* Minimum of 3 years of Healthcare Revenue Cycle Management billing experience, preferably in a behavioral health setting


* Minimum of 5 years with ICD-10 coding.

Billing and Coding certification is required


* Prior experience with Lean Six Sigma and Process Improvement methodology preferred


* Experience with CareLogic/qualifacts system preferred


* Experience billing through a clearinghouse, such as Inovolan highly preferred


* Strong understanding of Microsoft applications; i.e.

Excel, Outlook, Access, Word


* Ability to investigate problems and develop/communicate solutions


* Excellent oral, written, and interpersonal communication skills with a focus on customer service


* Ability to meet deadlines; highly detailed oriented; stro...