RCM Specialist

We are looking for a highly organized and detail-oriented Revenue Cycle Management Specialist to join our growing team. This role plays a critical part in ensuring accurate billing, authorization management, and payer compliance. The ideal candidate will have strong analytical skills, at least basic Excel skills, and experience navigating various healthcare payer portals.

We are looking for a highly organized and detail-oriented Revenue Cycle Management Specialist to join our growing team. This role plays a critical part in ensuring accurate billing, authorization management, and payer compliance. The ideal candidate will have strong analytical skills, at least basic Excel skills, and experience navigating various healthcare payer portals.

Authorization/Prebilling/Eligibility Responsibilities

• Data Entry & Verification:
• Accurately enter authorizations and required billing fields.

• Verify data across multiple systems including Billing System, CRM, Excel, and Healthcare Payer Portals.

• Payer Requirements:

• Understand and fulfill varying payer requirements, ensuring contractual obligations are met.

• Collaborate effectively with the RCM department.

• Problem-Solving & Research:

• Identify issues in standard operating processes and recognize patterns that deviate from expected procedures
• Research and address non-standard scenarios in the process.

• Communicate effectively with internal and external stakeholders.

• Account Management:

• Process adjustments on account ledgers and manage missing/expired or reach out to obtain correct authorizations.
• Handle outbound calls, terminations, and payer changes.

We specialize in delivering innovative solutions and exceptional services to meet the diverse needs of our clients. With a strong commitment to quality and customer satisfaction, we strive to exceed expectations and drive success in every project we undertake.