Revenue Cycle Specialist - Remote

Overview

Under the direction of the Supervisor of Revenue Cycle Management, the Revenue Cycle Management (RCM) Specialist is responsible for ensuring accurate billing and the timely submission of electronic and paper claims. This role includes monitoring claim status, researching and resolving denials or rejections, documenting account activities, and posting adjustments and collections. The RCM Specialist must demonstrate strong critical thinking skills and possess in-depth knowledge of Commercial, Medicaid, and Medicare eligibility requirements and contract guidelines.

In Short

• Identify and analyze denial trends to improve processes.
• Research and resolve unpaid, denied, and rejected claims.
• Handle EDI transactions and reconcile payer submissions.
• Collaborate with the Insurance Verification team.
• Complete collection activities in compliance with payer guidelines.
• Monitor patient accounts for non-payment and billing irregularities.
• Investigate and respond to patient billing inquiries.
• 3+ years of RCM experience preferred.
• Proficient in medical billing systems.
• Strong attention to detail and communication skills.

Requirements

• High school diploma or GED.
• 3+ years of RCM experience.
• Ability to analyze claims data and suggest improvements.
• Experience in digital or virtual health.
• Familiarity with Medicaid, Medicare, and commercial insurance billing.
• Commitment to HIPAA compliance.
• Strong customer service skills.
• Knowledge of medical coding principles.
• Ability to thrive in a fast-paced environment.
• Excellent oral and written communication skills.

Benefits

• 100% remote work opportunity.
• Monday - Friday work schedule.
• Equal opportunity employer.
• Diverse team culture.
• Opportunity to impact mental health care access.