RCM Specialist II - REMOTE

ROLE OVERVIEW

KEY RESPONSIBILITIES

• Perform all assigned RCM activities in accordance with best practices and internal SOPs.
• Perform AR follow-up to resolve unpaid or underpaid claims, denials, and aged balances through appropriate action (i.e. appeals, corrections, resubmissions, etc.)
• Audit accounts to verify accurate claim submission, payment application, adjustments, and resolution of outstanding balances.
• Review and resolve credit balances; process refunds to insurance and patients in compliance with regulations and internal policies.
• Post all payments – insurance and patient – accurately and in a timely manner, including zero-dollar payments and remittance reconciliations (manual and electronic).
• Apply adjustments and write-offs appropriately based on payer contracts and internal guidelines.
• Work AR aging reports regularly to reduce days in AR and the percentage of AR over 90 days.