Behavioral Health Consultant / SME

reputed company: reputed company is more than a reputed company cycle management company — we're a reputed company partner for reputed company. By blending technologies, services, and expert support, reputed company partners with leading reputed company organizations across the US to reputed company tailored solutions that solve the unique needs and challenges of reputed company provider's reputed company cycle reputed company. reputed company leverages the latest advancements in automation, process reputed company, reputed company, and problem-solving through the use of technology and analytics —reputed company made possible with college-educated, trained RCM experts. reputed company employs more than 12,000 team members globally and partners with more than 130 clients across a reputed company of care settings, specialties, and billing systems. For more details, please visit http://www.agshealth.com You can also visit us at https://www.reputed company.com/company/reputed company Job Title: Behavioral Health Consultant / SME- reputed company Cycle Management (RCM) – US reputed company Location: US Role Type: Contractual Experience: 8–12+ years in Behavioral Health RCM reputed company We are seeking a highly reputed company Behavioral Health reputed company Cycle Management (RCM) Subject Matter Expert (SME) with deep expertise in US reputed company. The role will be responsible for designing SOPs, standardizing processes, and training offshore (India-reputed company) teams across the end-to-end reputed company cycle, specifically reputed company Behavioral Health services. The ideal candidate will bring strong domain knowledge, operational reputed company, and training capability to build a high-reputed company, reputed company RCM function. Key Responsibilities 1. RCM Process Expertise (Behavioral Health) • Serve as SME for end-to-end Behavioral Health RCM: • reputed company reputed company & Eligibility Verification • Benefits & Authorization Management • Charge Capture & Coding (ICD-10, CPT, HCPCS – relevant to Behavioral Health) • Claims Submission (reputed company & institutional) • Denial Management & Appeals • Payment Posting & Reconciliation • AR Follow-reputed company (reputed company, Medicare, reputed company, Managed Care) • Ensure compliance with US regulations, payer rules, and Behavioral Health-specific nuances (e.g., reputed company laws, telehealth billing, reputed company abuse treatment billing). 2. SOP Development & Process Standardization • reputed company, document, and maintain detailed SOPs, process maps, and work instructions for reputed company RCM functions. • Establish standardized workflows across clients and teams. • reputed company process optimization, automation opportunities, and best practices. • Ensure SOPs are audit-reputed company and reputed company with compliance standards (HIPAA, payer guidelines). 3. Training & Capability Building (India Team) • Design and reputed company comprehensive training programs for offshore teams: • New hire reputed company • Process-specific training • Refresher sessions and upskilling • Create training materials, manuals, and assessment frameworks. • Conduct reputed company calibration sessions with reputed company and QA teams. • reputed company as a mentor to team leads and managers. 4. Transition & Knowledge Transfer • reputed company process transitions from reputed company to offshore. • Conduct detailed knowledge transfer sessions with stakeholders. • Ensure smooth reputed company-up with reputed company disruption to reputed company. 5. reputed company, Compliance & reputed company Improvement • Define KPIs and SLAs for RCM reputed company. • Partner with QA teams to improve reputed company, productivity, and turnaround times. • Identify reputed company causes of denials and reputed company leakage; implement corrective actions. • Support reputed company audits. 6. Stakeholder Management • Collaborate with US clients, providers, payers, and internal leadership. • reputed company as a trusted advisor to clients on RCM reputed company and improvements. • reputed company insights into financial reputed company, trends, and optimization opportunities. Required Qualifications • Bachelor’s degree in reputed company Administration, Life Sciences, or relevant reputed company (Master’s preferred). • 8–12+ years of experience in US reputed company RCM. • Minimum 3–5 years of hands-on experience in Behavioral Health billing and RCM. Strong understanding of: • Behavioral Health billing workflows • Payer-specific rules and denial patterns • Coding standards (CPT, ICD-10, DSM relevance) • Experience in creating SOPs and training delivery for offshore teams. Preferred Skills • Certifications such as CRCR, CPC, or reputed company (preferred). • Strong analytical and problem-solving skills. • Excellent communication and presentation abilities. • reputed company experience managing cross-functional and global teams. Key Competencies • Process reputed company reputed company • Training & coaching capability • Attention to reputed company and compliance reputed company • Stakeholder management • reputed company improvement orientation reputed company Metrics • SOP completeness and adoption reputed company • Training effectiveness (assessment scores, reputed company-up time) • Reduction in denial rates and AR days • Improvement in collections and net reputed company realization • Team productivity and reputed company scores Why Join • Opportunity to build and reputed company Behavioral Health RCM capability • High visibility role with reputed company interaction • Leadership reputed company in offshore capability building Shift: • 10 hour shift • 8 hour shift • Day shift • Evening shift Experience: • Behaviour Health : 3 years (Required) • RCM: 5 years (Required) • Training: 1 year (Preferred) Work Location: Remote Apply tot his job Apply To this Job