RCM - CLAIMS SPECIALIST

***** Not a remote position *****

Overview

Join our dynamic team as a RCM - CLAIMS SPECIALIST, where you will play a vital role in optimizing revenue cycle management processes by ensuring accurate and timely claims processing. This position offers an exciting opportunity to work with cutting-edge EMR (Electronic Medical Records) and EHR (Electronic Health Records) systems, utilizing your expertise in medical coding and billing to support healthcare providers’ financial health. Your proactive approach will help streamline claims submission, resolve denials efficiently, and enhance overall revenue cycle performance. If you thrive in a fast-paced environment that values precision and teamwork, this role is perfect for you!

Duties

• Review and analyze medical claims for accuracy, completeness, and compliance with insurance requirements using knowledge of DRG (Diagnosis-Related Group), CPT coding, ICD-10, and ICD-10 standards.
• Ensure proper documentation of medical records, including medical terminology and records management, to support claims submissions.
• Utilize EMR and EHR systems to input, track, and manage claims data effectively throughout the billing cycle.
• Identify and resolve claim denials or rejections promptly by investigating issues related to coding errors or incomplete information.
• Collaborate with healthcare providers and insurance companies to facilitate medical collections and expedite payment processes.
• Maintain detailed records of all billing activities, adjustments, and correspondence related to claims processing.
• Stay updated on industry regulations and coding guidelines to ensure compliance and optimize reimbursement strategies.

Experience

• Proven experience in medical billing, coding, or revenue cycle management within a healthcare setting.
• Strong knowledge of DRG classifications, CPT coding procedures, ICD-9/ICD-10 coding standards, and medical terminology.
• Familiarity with EMR/EHR systems for efficient claims entry and tracking.
• Experience handling medical records review for billing purposes and supporting documentation verification.
• Demonstrated ability to perform medical collection activities with professionalism and persistence.
• Excellent attention to detail combined with strong organizational skills to manage multiple claims simultaneously.
• Prior experience working in a fast-paced office environment with a focus on accuracy and compliance. Embark on a rewarding career where your expertise directly impacts healthcare delivery by ensuring accurate reimbursements while supporting the financial health of healthcare providers. We value energetic professionals committed to excellence in medical billing and claims processing!
• E Clinical works is a plus.
• Medical claims experience 2-5 years
• Work week Monday - Thurs 7-5 // off on Fridays!

Pay: $15.00 - $17.00 per hour

Work Location: In person