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.
The Revenue Cycle Manager is responsible for overseeing revenue cycle management including billing, collections, and denial management as well as financial reporting within the organization. This position is responsible for ensuring claims, denials, and appeals are efficiently processed, and billing-related issues resolved promptly. The Revenue Cycle Manager will minimize bad debt, improve cash flow, and effectively manage accounts receivables. This position must be aware of payer regulations and guidelines. Please Note: This position is on-site at our office in Middletown, PA.
Job Responsibilities:
- Responsible for providing high quality service to all clients as it relates to revenue cycle management
- Manage the day-to-day operations of the billing department
- Guide the daily, weekly and monthly financial reporting
- Manage team members as assigned
- Assist in recruitment and hiring of all operations personnel
- As a leader in the organization, demonstrate appropriate conduct and positive attitude to foster creativity, innovation and a culture of success
- Assist team members with problem resolution
- Ensure effective communication with both internal and external stakeholders
- Interact daily with team members to ensure accurate transfer of information
- Track and monitor the claim volumes billed to all payers and report weekly
- Initiate all communication with payers on behalf of our clients
- Document all interaction with payers
- Adhere to all company policies and procedures
- Conduct business in a safe, compliant and secure manner as it relates to HIPAA and patient privacy
- Other duties as assigned
Required Education and Qualifications:
- A bachelor’s degree and 5-7 years of related work experience
- Knowledge of third-party payer requirements including federal, state, and Commercial
- Proven experience in healthcare billing, including Medicaid and Managed Care
- Knowledge of basic insurance policies, procedures, and reimbursement practices
- Experience supervising staff
- Prior experience with process development and execution
- Excellent communication and interpersonal skills
About ZMark Health:
Founded by Matt in October 2020, ZMark Health brings over 20 years of expertise in healthcare reimbursement, finance, and managed services. With a strong focus on growth and client success, Matt has assembled a team of skilled leaders and professionals who are dedicated to delivering exceptional results. As we continue to expand, we’re looking for outstanding and talented individuals to join our team and contribute to our mission.
