Billing and Revenue Cycle Specialist for Behavioral Health Therapy

We're a Houston-based behavioral health agency billing roughly $800K/month across Texas Medicaid MCOs (Superior, TCHP, Driscoll, Optum, CHC, Wellpoint, Amerigroup). Our revenue cycle works, but it leaks. We need an experienced revenue cycle specialist to come in, diagnose where dollars are getting stuck, and rebuild our billing operation into a clean, repeatable weekly process. Current pain points we want fixed: Denial rate running ~14% (target: under 3%). Primary causes are authorization lapses, overdue treatment plans, and eligibility issues — all preventable upstream. ~5% of billable work each month sits in "documented but not submitted" limbo due to documentation/submission lag. Only about 65% of denied claims are getting appealed; the rest are silently written off. No tight reconciliation cadence between what was delivered, billed, paid, denied, and appealed. What you'll do Audit our current revenue cycle end-to-end and deliver a written findings + fix plan in the first 1–2 weeks. Build a denial-prevention workflow — authorization tracking with 30-day expiration alerts, treatment-plan due-date monitoring, and eligibility checks before submission. Stand up a denial management + appeals process so no appealable claim misses its deadline. Tighten the weekly billing cycle: clean-claim review, on-time first-pass submission, ERA/EOB posting within one business day. Create a simple A/R aging and billing-performance dashboard (clean-claim rate, denial rate, days in A/R, net collection rate) leadership can read at a glance. Document the rebuilt process as a repeatable SOP our internal team can run. Required 3+ years behavioral health billing / revenue cycle experience. Hands-on Texas Medicaid (TMHP), STAR/CHIP, and MCO billing — Superior, TCHP, Driscoll, Optum strongly preferred. Proven denial management and appeals track record (please cite a before/after denial-rate or A/R improvement you delivered). Strong with authorization workflows, CMS-1500, behavioral health codes/modifiers (H2014 (Skills Training), T1017 (Routine Case Management), T1016 (Targeted Case Management), therapy CPT codes (90832, 90834, 90837, 90847, 90853), medication management codes (99213, 99214), ERA/EFT. Excel/Sheets fluency for A/R aging and reporting. ICANotes EHR experience. Availity clearing house experience Familiarity with Texas CMBHS / HHSC behavioral health rules. CPB, CMRS, or equivalent certification. Strong English language communication and advocacy skills. To apply, tell us: (1) a behavioral health billing cleanup you've done and the measurable result, (2) your experience with the specific Texas MCOs above, and (3) your availability and rate.