RCM Specialist III

Are you an experienced medical billing professional who thrives on solving complex claim issues and driving revenue cycle performance? We're looking for a Billing & Collections Specialist to join our team and play a key role in ensuring timely and accurate reimbursement while supporting exceptional service for our health centers and patients.

If you're detail-oriented, customer-focused, and experienced in medical billing, insurance follow-up, denial management, and account resolution, we'd love to hear from you.

What You'll Do

Billing & Claims Management

• Prepare and submit clean claims to insurance carriers electronically and via paper as needed.
• Review claims for accuracy and identify billing or coding issues requiring corrections, rebilling, or secondary billing.
• Research and resolve claim rejections, holds, denials, and payment variances.
• Verify patient eligibility, benefits, and insurance coverage.
• Follow up with insurance carriers regarding unpaid and underpaid claims to ensure timely reimbursement.
• Maintain compliance with payer guidelines and billing requirements.

Accounts Receivable & Collections

• Research outstanding accounts receivable and initiate corrections related to patient demographics, insurance information, provider data, claim details, and modifiers.
• Assist with patient collections and deposit reconciliation activities.
• Accurately document all account activity, communications, and transactions within patient accounts.
• Monitor aging accounts and identify opportunities to improve collection performance.

Customer Service & Collaboration

• Communicate professionally with patients, providers, insurance carriers, and internal stakeholders via phone, email, and written correspondence.
• Provide exceptional customer service while resolving billing and payment inquiries.
• Collaborate with Revenue Cycle Management team members to ensure operational efficiency.
• Cross-train and provide support across Revenue Cycle functions, including payment posting, reconciliation, customer service, and billing operations.

Process Improvement & Operational Support

• Identify billing trends, recurring issues, and opportunities for process improvement.
• Support departmental initiatives designed to improve claim accuracy, cash collections, and reimbursement outcomes.
• Adapt to changing business needs and perform additional responsibilities as assigned.

What You'll Bring

Required Qualifications

• High School Diploma or GED.
• Minimum of 2-3 years of experience in medical billing, insurance collections, accounts receivable, or denial management.
• Experience working with Medicare, Medicaid, and commercial insurance payers.
• Knowledge of medical terminology, insurance guidelines, and billing regulations.
• Strong analytical, organizational, and problem-solving skills.
• Excellent verbal and written communication skills.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
• Ability to work independently while maintaining a collaborative team approach.

Preferred Qualifications

• Experience working within an Electronic Medical Record (EMR) system.
• EPIC experience and/or certification.
• Experience with denial management, insurance follow-up, and revenue cycle operations.

Why Join Us?

At our organization, you'll have the opportunity to support a mission focused on improving community health while helping ensure the financial health of the health centers we serve. Your expertise will play a critical role in optimizing revenue cycle performance, improving operational efficiency, and supporting access to quality healthcare services.

What We Offer

100% Remote Work – Work from anywhere within the United States.

100% Employer-Paid Medical Insurance – Comprehensive medical coverage at no cost to employees on one of our health plans.

Annual $1,500 HSA Contribution – Additional support to help manage healthcare expenses.

Generous Paid Time Off (PTO) – Take the time you need to rest, recharge, and maintain work-life balance.

403(b) Retirement Plan with Employer Contribution – Invest in your future with retirement savings support.

Professional Development & Education Assistance – Grow your skills through ongoing learning, certifications, and educational opportunities.