Rcm Specialist, Accounts Receivable

Summary

Join Help at Home, a leading provider of in-home personal care services, as an RCM Specialist, AR. Reporting to the RCM Supervisor or Manager, you will perform general data entry, keying, and bookkeeping tasks for accounts receivable. This role requires a high degree of attention to detail and problem-solving skills. You will be responsible for submitting claims, resolving rejections, maintaining accurate records, and performing billing analysis. Collaboration with internal and external teams is crucial. Success in this position requires strong communication, teamwork, and a commitment to accuracy.

Requirements

• Self-motivated; reliable; strong attention to detail; maintains confidentiality; complies with all Company policies and procedures
• Demonstrates excellent communication and customer service skills under duress at a fast pace; ability to function as a positive team member
• High School diploma or GED required
• One (1) to two (2) years’ experience of revenue cycle management or billing experience in the healthcare field
• Knowledge of Medicaid/Managed Care Organization (MCO) billing practices
• Experience with billing in an Electronic Data Interchange/3rd party clearinghouse environment
• Intermediate to advanced computer skills, including the use of Microsoft Office applications

Responsibilities

• Submits claims to payors in accordance with payor requirements and agency policy
• Receives notices of claim rejections & denials
• Properly track and resolve issues to ensure claim payment
• Maintains complete and accurate accounts receivable records
• Performs troubleshooting for billing error codes
• May work with the payer or branch operational team to identify and resolve issues
• Maintains accurate billing analysis reports and communicates implications promptly to the appropriate parties
• Analyzes daily reports from the state and matches the approved payments to the client
• Alerts the Operations Team and Manager regarding late or missing documents required for billing
• Assists with the collection of receivables by monitoring accounts receivables, resubmitting bills to overdue accounts, and alerting Manager regarding seriously overdue accounts
• Produces reports as needed
• Performs administrative duties such as sorting, scanning, filing, and emailing records
• Performs other duties as assigned