About this role

Responsible for researching and resolving outstanding balances by following up on claim status
Manage the end-to-end A/R workflow including billing, payment posting, adjustments, reconciliation, claim follow-up, and resolution
Ensure timely and accurate submission of claims across commercial, Medicare, Medicaid, and managed care payers
Conduct detailed review of denied or underpaid claims to determine root causes and corrective actions
Communicate with insurance carriers via phone, email, fax, and portal correspondence to resolve outstanding issues

High school diploma or GED
Minimum 1 year of medical billing, claims, or A/R experience
Advanced Microsoft Excel skills (vlookups, pivot tables, data organization)
Strong analytical, investigative, and problem-solving skills
Excellent verbal and written communication skills
Basic understanding of insurance plans, medical terminology, Medicare and Medicaid billing guidelines

RCM Accounts Receivable Specialist

Key skills