RCM Coordinator - Claims Resolution

General Description

Are you looking for a purpose-driven career? At Metrocare, we serve our neighbors with developmental or mental health challenges by helping them find lives that are meaningful and satisfying. Metrocare is the largest provider of mental health services in North Texas, serving over 55,000 adults and children annually. For over 50 years, Metrocare has provided a broad array of services to people with mental health challenges and developmental disabilities.

In addition to behavioral health care, Metrocare provides primary care centers for adults and children, services for veterans and their families, accessible pharmacies, housing, and supportive social services. Alongside clinical care, researchers and teachers from Metrocare’s Altshuler Center for Education & Research are advancing mental health beyond Dallas County while providing critical workforce to the state.

The mission of Metrocare Services is to serve our neighbors with developmental or mental health challenges by helping them find lives that are meaningful and satisfying. We are an agency committed to quality gender-responsive, trauma-informed care to individuals experiencing serious mental illness, developmental disabilities, and co-occurring disorders. Metrocare programs focus on the issues that matter most in the lives of the children, families and adults we serve.

The RCM Coordinator – Claims Resolution serves as a key financial liaison within the Revenue Cycle Management team, responsible for ensuring the integrity of claim submission, payment accuracy, and denial prevention across multiple service lines including primary care, behavioral health, intellectual and developmental disability (IDD) services, early childhood intervention (ECI), applied behavior analysis (ABA) therapy, and LIDDA programs. This position requires advanced understanding of payer policy variations, reimbursement methodologies, and system workflows.

The role coordinates closely with clinical, compliance, and finance teams to safeguard and optimize agency revenue performance.

• Prepare, review, and submit claims for primary care, behavioral health, IDD, ECI, ABA therapy, and LIDDA services to Medicaid, Medicare, and commercial payers.
• Monitor claim status and ensure timely acceptance, adjudication, and payment across multiple service lines.
• Research and resolve claim denials, rejections, and underpayments specific to medical, behavioral health, and developmental disability services.
• Partner with clinical and administrative teams to ensure proper coding, documentation, and authorization for services provided.
• Maintain current knowledge of payer policies, rules, and regulatory requirements for mental health, primary care, ABA therapy, IDD, ECI, and LIDDA programs.
• Track denial and rejection trends across all service areas, identify root causes, and recommend corrective action.
• Document claim activity, correspondence, and resolution steps accurately in the billing system.
• Provide reporting and analysis to management regarding claim performance, payer trends, and process improvement opportunities.
• Collaborate with the Revenue Cycle Management team to ensure compliance and revenue integrity across all program areas.
• Performs other duties as assigned.

• Conducts job responsibilities in accordance with the ethical standards of conduct, state contract, appropriate professional standards and applicable state/federal laws.
• Analytical skills, professional acumen, business ethics, thorough understanding of continuous improvement processes, problem solving, respect for confidentiality, and excellent communication skills.

• Maintain