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Billing/EV RCM Team Lead - Mental Health / Behavioral Health Focus Summary Industry: Healthcare Technology / Revenue Cycle Management (RCM) Hours: Full-Time, US Business Hours (e.g., 8 AM - 5 PM EST) Salary: Competitive USD Rate (Based on extensive experience) Job Overview We are a rapidly growing US healthcare technology company that is revolutionizing healthcare payments by bringing speed, accuracy, and transparency to the Revenue Cycle Management (RCM) process. We are seeking an exceptional and highly experienced Team Lead to oversee a critical, specialized division within our RCM operations. This is a crucial leadership role that will manage teams focused on high-value RCM functions, including Denial Management, Accounts Receivable (AR) Follow-up, and Coding/Billing specifically for Mental Health and Behavioral Health practices (EV stands for Eligibility/Verification in this context). You will be instrumental in driving team performance, ensuring specialized billing accuracy, and optimizing processes to maximize reimbursement in this complex specialty. Key Responsibilities Mental Health RCM Oversight: Serve as the subject matter expert and primary leader for all RCM activities related to Mental and Behavioral Health billing, ensuring compliance with all state and federal regulations, including HIPAA and specific parity laws. -Eligibility & Verification (EV) Management: Oversee the Eligibility/Verification process to ensure accurate benefits checks, pre-authorization tracking, and intake documentation for all behavioral health services. -Team Leadership & Management: Directly supervise, train, and mentor a remote team of specialized Billing and RCM Associates across divisions (e.g., Denial Management, AR Follow-up, Eligibility/Verification). -Specialty Denial Strategy: Lead the Denial Management division, performing root cause analysis on recurring Mental Health denials (e.g., necessity, authorization, plan coverage) and developing strategic, effective appeal processes specific to behavioral health. -Performance Monitoring: Set clear performance metrics (KPIs) for each team, monitor daily productivity and quality assurance (QA) scores, and conduct regular performance reviews. -Process Excellence: Develop, document, and enforce standardized billing, EV, follow-up, and denial resolution workflows to ensure maximum reimbursement and compliance. -System Optimization: Actively utilize and provide feedback on our internal billing platform to identify areas for efficiency gains within your teams' workflows, particularly for authorization tracking and high-volume specialty claims. -Escalation Point: Serve as the primary point of escalation for complex billing issues, payer disputes, and high-value denials, especially those unique to mental health services. Required Skills & Experience 4+ years of direct, hands-on experience in end-to-end US Healthcare RCM (Billing, AR, and Denial Management). 2+ years of experience as a Team Lead, Supervisor, or Manager overseeing a US medical billing team. EXTENSIVE & IN-DEPTH EXPERIENCE is MANDATORY: Proven expertise in Mental Health / Behavioral Health (BH) RCM, including: -Thorough knowledge of CPT/HCPCS codes and modifiers specific to BH services (e.g., 908xx, tele-health modifiers). -Expertise in Eligibility, Verification, and Pre-Authorization/Referral Management (EV). -Deep understanding of Medical Necessity criteria and documentation requirements for BH claims. -In-depth knowledge of insurance claim filing (CMS-1500), denial codes, payer policies, and appeal processes for major US payers. -Proven ability to analyze RCM data (e.g., denial rates, collection rates) and implement effective process improvements. -Strong leadership, coaching, and organizational skills, with a focus on managing a high-performing remote team.