Location: Remote
Employment: Full time
Position Overview:
ROMTech now seeks an experienced Revenue Cycle Management (RCM) Generalist to play a key role in the day-to-day operations of the revenue cycle by performing various duties related to patient billing, coding, claims processing, and collections. The role ensures that claims are accurately submitted, payments are collected timely, and any billing discrepancies are resolved in compliance with healthcare regulations. The ideal candidate is self-motivated with a high attention to detail and is skilled in all aspects of the revenue cycle and able to step in and assist were needed. This is a full time, remote opportunity.
Responsibilities:
Billing and Coding-
- Ensure the accurate coding of medical procedures and diagnoses based on ICD-10, CPT, and HCPCS codes.
- Submit claims to insurance providers and ensure they meet all payer-specific guidelines.
Claims Management-
- Monitor and track the status of claims, including resolving denials and rejections.
- Work with insurance companies to resolve any issues related to claim processing or payments.
- Appeal denied claims as needed and follow up on outstanding claims.
Payment Posting and Reconciliation-
- Post payments received from insurance providers, patients, and other sources to patient accounts.
- Reconcile payments with patient balances and resolve discrepancies.
Patient Billing-
- Review and prepare patient statements, ensuring accuracy in charges, insurance payments, and patient responsibility.
- Handle patient inquiries regarding billing issues, payment plans, or insurance coverage.
Collections and Follow-up-
- Coordinate the collection of overdue payments and follow up on outstanding accounts.
- Work with patients to set up payment plans or assist in addressing financial concerns.
Compliance and Reporting-
- Ensure that all revenue cycle activities comply with applicable healthcare laws, regulations, and payer policies.
- Generate and review reports on revenue cycle performance, identifying trends, issues, and areas for improvement.
Collaboration-
- Work closely with clinical and administrative staff to ensure accurate patient information and timely claim submission.
- Communicate with insurance companies, patients, and other stakeholders to resolve issues related to billing and payments.
Continuous Improvement-
- Participate in identifying opportunities for improving processes and workflows within the revenue cycle.
- Stay updated on changes in healthcare regulations, coding updates, and insurance policies.
Requirements:
- Minimum of 4-7 years of experience in Revenue Cycle Management, Medical Billing, or Coding.
- Experience with Electronic Health Record (EHR) Systems and billing software.
- Certified Professional Coder (CPC) or Certified Coding Specialist (CCS), preferred.
- Certified Revenue Cycle Representative (CRCR), preferred.
- Strong understanding of insurance billing, coding, and claims processes.
- Strong background in all aspects of the Revenue Cycle Management process.
- Knowledge of medical terminology, ICD-10, CPT, and HCPCS coding.
- Excellent problem-solving and analytical skills.
- Strong attention to detail and ability to multitask.
- Effective communication skills, both written and verbal.
- Ability to work independently and as part of a team
- Ability to sit at a computer terminal for an extended period.
- Moderate noise (i.e., phone calls, online meetings, computer audio)
- While performing the duties of this job, the employee may be regularly required to stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard.
- Specific vision abilities required by this job include close vision requirements due to computer work.
- Regular, predictable attendance is required.
If this sounds like an exciting opportunity to embark in the next chapter of your career, we welcome you to apply with your up-to-date resume. We look forward to hearing from you!
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit for extended periods of time and use hands to operate a computer and other office equipment. The employee is frequently required to reach with hands and arms, talk, and hear. Specific vision abilities required by this job include close vision and the ability to adjust focus.
We are an equal opportunity employer. Qualified Applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status, or any other classification protected under applicable Federal, State or Local law.