Virtual Revenue Cycle Management (RCM) Specialist - Provider Side

1+ years in RCM, medical billing, or provider-side revenue cycle. Experience with EHR/EMR systems (Epic, AthenaHealth, eClinicalWorks, Kareo, etc.). Proficiency in medical billing software and Microsoft Office (Excel, Word). Ability to analyze financial data and provide insights for better revenue management.

Submit accurate and timely claims to insurance companies (commercial, Medicare, Medicaid). Verify patient insurance eligibility and benefits before services are rendered. Ensure correct coding using CPT, ICD-10, and HCPCS codes to prevent denials. Post payments from insurance providers and patients into the system. Reconcile discrepancies in payments and address underpayments. Analyze denied claims, determine root causes, and submit timely appeals. Communicate with payers to resolve claim issues and secure reimbursements. Manage patient statements, outstanding balances, and payment plans. Educate patients on their financial responsibilities, including deductibles and copays. Ensure adherence to HIPAA regulations, payer guidelines, and industry standards. Generate and analyze RCM reports (e.g., A/R aging, collection rates, denial trends). Work closely with providers, payers, and internal teams to improve revenue cycle efficiency.