RCM Specialist

RCM Specialist

• AR Specialist
• Complex claim resolution specialist
• Collections Specialist

Must have substance abuse and mental health billing experience to be considered.

Job Summary
We are seeking a dedicated and detail-oriented RCM Specialist to join our team. The ideal candidate will possess a strong understanding of medical terminology and coding, with experience in medical billing and collections. This role encapsulates experience in claims, AR, and/or collections. The individual needs to have experience working with SUD/MH companies. Preferably a candidate coming from another 3rd party billing company.

Responsibilities:

• Make a high volume of claim follow-up calls, with talk times averaging over 3 hours per day.
• Exhibit strong telephone communication skills to ensure effective interactions with stakeholders.
• Demonstrate responsibility, punctuality, and a proactive approach to learning and problem-solving.
• Work both independently and collaboratively as part of a team.
• Perform data entry for codes and charges, and conduct AR follow-up with commercial insurances, addressing work denials, rejections, and other related tasks.
• Review Explanation of Benefits (EOBs) for proper reimbursement accuracy.
• Verify patient coverage and assist with billing inquiries.
• Analyze unpaid or denied claims and submit appeals promptly when required.
• Ensure timely collection of outstanding accounts receivable (A/R), executing clerical and accounting tasks to resolve billing discrepancies.
• Conduct claim auditing and manage status delegation effectively.
• Create and submit appeals for denied claims, ensuring compliance with payer guidelines.
• Collaborate effectively with offshore team members, providing guidance and oversight as needed.
• Utilize advanced computer skills with proficiency in Microsoft Office tools.
• Deliver exceptional customer service with strong verbal and written communication capabilities.
• Exhibit multitasking skills and function efficiently in a fast-paced environment.
• Maintain excellent attention to detail and organizational skills to ensure accurate and timely work.

Job Type: Full-time

Pay: $53,000.00 - $59,000.00 per year

Benefits:

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• Behavioral health: 2 years (Required)
• collections: 1 year (Preferred)
• OON insurance: 1 year (Required)
• claims follow-up: 1 year (Preferred)
• claims resolution: 1 year (Preferred)

Ability to Relocate:

• Newport Beach, CA 92660: Relocate before starting work (Required)

Work Location: Hybrid remote in Newport Beach, CA 92660

Salary : $53,000 - $59,000