The Revenue Cycle Management (RCM) Specialist is responsible for complex claim resolution for Behavioral & Mental Health commercial insurance claims. This includes managing the claims revenue cycle for multiple facility accounts and a extensive understanding of commercial insurance billing & collections. The role requires advanced skills in handling complex denials, conducting appeals, managing rejections to ensure accurate and timely reimbursement.
- Must be comfortable making a high volume of claim follow-up calls
- Talk times typically are above 3 hours a day
- Strong telephone communication skills needed
- Must be extremely responsible, punctual and someone who learns fast
- Ability to work independently and with team members
- Data Entry codes and charges, AR follow-up with insurances, work denials, rejections, etc...
- Reviewing of EOBs for proper reimbursement
- Verifying patient coverage and assist with patient billing inquiries
- Review unpaid and/or denied claims and submit appeals as needed
- Ensure timely collection of outstanding A/R and perform a variety of clerical and accounting functions to resolve billing issues of submitted claims
- Perform all other Medical Billing duties as assigned
- Claim auditing and status delegation
- Appeal Creation and Submission
- Excellent computer skills with proficiency using Microsoft Office
- Exceptional customer service and both verbal and written communications skills
- Must be a team player and be willing to multitask
- Attention to detail and must be organized
Job Type: Full-time
Benefits:
- 401(k)
- Health insurance
- Vision insurance
- Dental insurance
- Paid time off
- Work from home