Are you a detail-oriented professional with a passion for healthcare billing and revenue cycle optimization? Join our team as an RCM Specialist, where you’ll play a critical role in managing the full spectrum of revenue cycle activities—from benefit verification and authorization to claim submission and collections. This is a dynamic, independent role ideal for someone who thrives in a fast-paced environment and is committed to accuracy and efficiency. Please Note: This position is on-site at our office in Middletown, PA.
Key Responsibilities:
- Verify patient benefits and manage authorizations for mental health services.
- Submit claims within established timeframes and monitor their progress.
- Navigate payer portals and EMR dashboards to complete tasks and follow-ups.
- Investigate and resolve unbilled charges and unpaid claims.
- Track and analyze billing and collection trends to identify improvement opportunities.
- Lead collection efforts for assigned payers, including secondary insurance claims.
- Escalate unresolved claims appropriately, both internally and externally.
- Collaborate across departments to streamline the AR recovery process.
- Maintain clear and professional communication with internal teams and external stakeholders.
- Ensure accurate documentation of all payer interactions.
- Uphold HIPAA compliance and patient privacy standards.
- Perform other duties as assigned.
Qualifications:
- High School diploma or equivalent; 3–5 years of relevant experience.
- Strong understanding of third-party payer requirements (federal, state, commercial).
- Proven track record in healthcare billing, including Medicaid and Managed Care.
- Familiarity with EMR systems (preferred).
- Solid grasp of insurance policies, procedures, and reimbursement practices.
- Highly organized with strong attention to detail.
- Experience in process development and execution.
- Excellent communication and interpersonal skills.
- Proficient in Microsoft Office, especially Excel.