RCM Specialist
New
R
Reklame HealthBehavioral Health
Remote (U.S.) required, Eastern Time preferredFull-TimeMiddle
Salary60,000 - 80,000 USD per year
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Job Details
- Experience
- Minimum of 3 years of professional experience in medical coding and billing required.
- Required Skills
- EHRHIPAA
Requirements
- Minimum 3 years of professional experience in medical coding and billing.
- Advanced proficiency with ICD-10, CPT, and HCPCS coding systems.
- Experience working with EHR systems, clinical notes, and medical billing software.
- Strong understanding of payer patterns and HIPAA/healthcare compliance guidelines.
- Analytical mindset with ability to manage complex cases and identify process improvements.
- Exceptional attention to detail in documentation and coding.
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) strongly preferred.
- Behavioral health claim management experience strongly preferred.
Responsibilities
- Improve first-pass claim acceptance by ensuring correct coding and flagging inconsistencies.
- Review EOBs and denial trends to identify and implement solutions.
- Partner with vendors to translate requirements into tools and update clinical workflows.
- Resolve claim issues in collaboration with billing team and senior management.
- Review clinical documentation (SOAP notes) and perform CPT/ICD-10 coding for complex cases.
- Maintain reference guides for coding corrections.
- Ensure alignment with CMS, state Medicaid, and managed-care guidelines.
- Monitor payer policy changes and ensure optimized billing practices.
- Collaborate on the implementation of new payer contracts.
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