Coding & RCM Specialist

Sixty million adults experience mental health challenges in the United States, yet one-third lack access to proper care. Opioid overdose is the number one cause of death for people under 50 in the United States. 

We are a clinician-led, tech-enabled provider group that exists to provide culturally competent behavioral health care addiction care, medication management, crisis intervention, and care coordination for people working towards taking back control of their lives, while expanding access to care.

Our vision at ReKlame Health is to create a future where individuals who have historically been unable to access the care they deserve can readily obtain high-quality behavioral health and addiction care. 

At ReKlame Health, it goes beyond mere employment; it's about becoming a part of a formidable movement transcending individuality. Let's unite and forge a world where health equity and effortless access to exceptional mental healthcare can co-exist.

We are seeking a detail-oriented Coding & RCM Specialist to support accurate coding and clean claims submission in a complex Medicaid and managed-care environment. This is a hands-on, production-focused role centered on CPT and ICD-10 coding accuracy and documentation review.

You will partner with Revenue Cycle, Clinical Operations, and Finance to ensure services are coded correctly, documentation supports billed services, and common denial risks are caught early. This role is ideal for someone with 3–5 years of coding experience who enjoys detail-oriented work, pattern recognition, and improving claim quality through consistent execution.

• Coding & Claim Accuracy

  • 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.

• Audit & Quality Review Support

  • 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.

• RCM Collaboration

  • 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.

• Compliance & Coding Standards

  • 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.

• Certifications: Certified Professional Coder (CPC) or Certified Coding Specialist (CCS).

• Technical Skills: Advanced proficiency with ICD-10, CPT, and HCPCS coding systems. Experience working with EHR systems, clinical notes, and medical billing software required.

  • Experience working with RCM and billing vendors is a strong plus.

• Experience: Minimum of 3-5 years of professional experience in medical coding and billing required.

  • Strong preference for candidates with experience in behavioral health coding and expertise in Medicaid and managed-care systems.

• Detail-Oriented: Exceptional accuracy and attention to detail in coding/billing and documentation.

• Regulatory Knowledge: Strong understanding of HIPAA and healthcare compliance guidelines, with the ability to adapt to changing regulations.

  • Experience with denial resolutions, coding audits, and QA review preferred.

• Problem-Solving Expertise: Analytical mindset with the ability to address complex challenges, identify solutions, and implement improvements with speed and accuracy. Must be comfortable with EOBs, patterns, and payer behavior.

• Annual Compensation: $60,000-85,000 (full-time)

• 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.

ReKlame Health considers several factors to ensure a fair and competitive offer when evaluating compensation packages. These include the scope and responsibilities of the role, the candidate's work experience, education, and training, as well as their essential skills. Internal peer equity is also examined to maintain balance within the organization. Additionally, current market conditions and overall organizational needs are crucial in shaping the final offer. Each aspect is thoughtfully reviewed before extending an offer, ensuring a comprehensive and equitable approach.

ReKlame Health is an equal opportunity employer. We celebrate diversity and are committed to creating a supportive and inclusive environment for all employees.

If you’re hungry for a challenge in 2025, love solving problems, and want to be a part of something transformational, we’d love to hear from you!

Learn more about us at www.ReKlamehealth.com

*We never ask for money or sensitive personal information during the job application process. If you receive an email or message claiming to be from us that requests such information, please do not respond and report it as a scam.