Job Summary
We are seeking a proactive and detail-oriented RCM (Revenue Cycle Management) Specialist to join our dynamic billing team. The RCM Specialist is responsible for performing essential revenue cycle functions, including insurance verification, medical billing, accounts receivable follow-up, and payment posting. This role requires strong attention to detail, a solid understanding of payer requirements, and the ability to manage multiple priorities while ensuring billing accuracy and compliance.
Responsibilities
Insurance Verification
- Verify patient insurance eligibility and coverage prior to or following services, ensuring accurate and complete documentation.
- Identify coverage limitations, authorization requirements, and payer-specific guidelines to support clean claim submission.
Billing & Claims Processing
- Prepare, review, and submit medical claims to insurance companies and third-party payers using electronic and paper submission methods as required.
- Ensure claims are coded and billed accurately according to payer guidelines and internal standards.
Accounts Receivable Management
- Monitor and manage accounts receivable to ensure timely reimbursement.
- Follow up on unpaid, denied, or underpaid claims, including researching issues and initiating appropriate resolution.
- Communicate with insurance payers to resolve claim discrepancies and payment delays.
Payment Posting
- Accurately post payments, contractual adjustments, and refunds to patient accounts.
- Reconcile payment variances and ensure proper documentation and account balance accuracy.
Customer Service
- Respond to billing-related inquiries from patients, providers, and insurance companies in a professional and timely manner.
- Provide clear explanations regarding charges, payments, and account balances as needed.
Compliance & Accuracy
- Ensure all billing activities comply with HIPAA regulations, payer policies, and internal procedures.
- Maintain accurate records and documentation to support audits and reporting requirements.
Qualifications
- Associate’s degree or higher in Healthcare Administration, Accounting, or a related field preferred.
- Minimum of 3–5 years of experience in medical billing; urgent care or primary care experience strongly preferred.
- Working knowledge of insurance verification, claim submission, accounts receivable follow-up, and payment posting.
- Proficiency in billing software and electronic health record (EHR) systems.
- Strong attention to detail with excellent organizational and time management skills.
- Effective written and verbal communication skills.
- Ability to work independently while contributing positively to a team environment.
Pay: $23.00 - $25.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: Remote
