RCM Associate, Member AR & Pre-Access (Contractor)
S
Sword HealthHealthcare billing
Remote - USContractMiddle
SalaryTotal Compensation Range €22 — €25 EUR
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Job Details
- Experience
- 3+ years of Revenue Cycle Management experience
- Required Skills
- Microsoft ExcelMicrosoft Office
Requirements
- Have 3+ years of Revenue Cycle Management experience, with working knowledge of medical billing claims.
- Have familiarity with financial clearance, insurance verification, or authorizations.
- Have experience speaking directly with members or patients about billing or insurance.
- Have working knowledge of billing, coding, and claims follow-up.
- Have experience communicating with payers to resolve issues.
- Be proficient in Excel and comfortable with basic data analysis.
- Be comfortable with claims billing software and Microsoft Office, and willing to learn new tools.
- Be able to work across multiple systems and workflows.
- Demonstrate attention to detail and problem-solving skills.
- Demonstrate communication and interpersonal skills.
- Be a self-starter who asks questions and learns quickly.
- Preferred: experience in behavioral health, mental health, telehealth, or digital health billing.
- Preferred: experience in B2B2C healthcare or exposure to health plan / EAP.
Responsibilities
- Review authorization, referral, and eligibility issues from the billing team and work them to resolution while meeting productivity and quality targets.
- Apply payer-specific requirements, including authorizations, referrals, carve-outs, and TPA plans.
- Communicate with members to obtain financial information and verify insurance coverage.
- Calculate member financial responsibility and provide cost estimates; review billing activity and transaction history to answer member billing questions.
- Record and reconcile member payments in the practice system.
- Identify collection opportunities, including payment plans and hardship applications, and escalate as appropriate.
- Coordinate with the coding team, clinicians, and Member Support to resolve billing, coding, and collection questions.
- Maintain accurate member records in electronic medical record and billing systems; pull and review balance and authorization reports for trends.
- Flag workflow pain points, support workflow rollouts, and update standard operating procedure documentation.
- Partner with teammates and occasionally Product / Engineering to resolve RCM issues; uphold HIPAA guidelines and relevant regulations.
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