Revenue Cycle Management Specialist

Summary

Join MedVA as a Virtual RCM Specialist and contribute to the success of our client's revenue cycle management. You will manage various aspects of the revenue cycle, from patient registration to final payment, ensuring optimal revenue collection and regulatory compliance. Responsibilities include billing and claims management, payment posting and reconciliation, denial and appeals management, patient financial coordination, and compliance reporting. You will collaborate with providers, payers, and internal teams. A Bachelor's degree in a related field and 1+ years of relevant experience are preferred. The position offers a permanent work-from-home setup, competitive hourly rates, and a retirement savings plan.

Requirements

• 1+ years in RCM, medical billing, or provider-side revenue cycle
• Experience with EHR/EMR systems (Epic, AthenaHealth, eClinicalWorks, Kareo, etc.)
• Proficiency in medical billing software and Microsoft Office (Excel, Word)
• Ability to analyze financial data and provide insights for better revenue management

Responsibilities

• Submit accurate and timely claims to insurance companies (commercial, Medicare, Medicaid)
• Verify patient insurance eligibility and benefits before services are rendered
• Ensure correct coding using CPT, ICD-10, and HCPCS codes to prevent denials
• Post payments from insurance providers and patients into the system
• Reconcile discrepancies in payments and address underpayments
• Analyze denied claims, determine root causes, and submit timely appeals
• Communicate with payers to resolve claim issues and secure reimbursements
• Manage patient statements, outstanding balances, and payment plans
• Educate patients on their financial responsibilities, including deductibles and copays
• Ensure adherence to HIPAA regulations, payer guidelines, and industry standards
• Generate and analyze RCM reports (e.g., A/R aging, collection rates, denial trends)
• Work closely with providers, payers, and internal teams to improve revenue cycle efficiency

Preferred Qualifications

• Bachelor’s degree in Healthcare Administration, Finance, or related field
• Certified Professional Coder (CPC)
• Certified Medical Reimbursement Specialist (CMRS)
• Certified Revenue Cycle Representative (CRCR)
• Excellent analytical skills and attention to detail, with the ability to manage time effectively
• Strong communication and organizational skills
• Ability to work both independently and collaboratively in a team environment

Benefits

• Permanent work from home set up
• Competitive Hourly rate
• Retirement savings plan
• Quality Training