Virtual Revenue Cycle Management (RCM) Specialist - Provider Side

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Requirements:

• 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.

Responsibilities:

• 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.