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

CA Billing jobs

RCM Specialist