RCM AR Specialist - Remote

Overview

The RCM A/R Specialist is responsible for managing the back-end billing and collections cycle, requiring expertise in medical claims and payer regulations.

In Short

• Review denied claims based on assigned markets and payers.
• Process requests for denied claims information using portals and calls.
• Research and respond to documentation requests from insurance carriers.
• Process appeals of insurance denials and follow-up until resolved.
• Update patient demographics and insurance information in systems.
• Follow-up on claims submitted to payers within timely filing limits.
• Document activities performed in the system for each account.
• Adhere to HIPAA guidelines and regulations.
• Maintain productivity and quality expectations.
• Alert management to irregularities and trends in reimbursement.

Requirements

• Bachelor's Degree or equivalent experience.
• 3+ years of experience in denial management.
• Prior experience with out-of-network denials and value-based claims.
• Proficient in CPT and ICD-10 coding terminology.
• Strong relationship building skills.
• Ability to work independently in a fast-paced environment.

Benefits

• Remote work with quarterly team meetings.
• Opportunity to make a difference in addiction recovery.
• Supportive work environment focused on community service.