Overview
This is a temporary 12-week full-time assignment for a Revenue Cycle Specialist I, with potential for permanent placement based on performance and business needs. The position is remote but requires residency in one of the following states: AZ, DE, FL, LA, MA, MD, MI, NC, OH, OR, PA, TN, TX, UT, or WA. Typical work hours are Monday through Friday, 8:00 AM to 5:00 PM, though hours may vary by state.
Responsibilities
- Manage and maintain a workload of approximately 70 claims daily to resolution.
- Collaborate and communicate daily using Microsoft Teams and utilize Microsoft Office products, primarily Excel.
- Work with other revenue cycle management (RCM) staff to ensure timely completion of billing functions.
- Review outstanding claims, make status calls to insurance companies, and request reprocessing when necessary.
- Prepare and submit corrected claims or appeals; adjust claims deemed non-reimbursable.
- Monitor payer project work queues, move claims between queues, and document actions.
- Review underpayments and overpayments, prepare summaries, and escalate issues as appropriate.
- Post contractual allowances based on fee schedules or expected payment/denial amounts.
- Contact insurers regarding recoupments, double debits, overpayments, and missing checks; initiate dispute processes as needed.
- Investigate claim receipts and payer portals to maximize reimbursement.
- Create and distribute reports such as account detail and unbilled reports for follow-up.
- Prepare and submit denied claims project files to payers and track reprocessing.
- Provide feedback on project status to departments and payers.
- Maintain tracking sheets of pending and resolved issues.
- Schedule and attend departmental meetings and conference calls.
- Apply knowledge of CPT, HCPCS, and ICD-10 codes.
- Identify claim trends and contract violations; report findings to management.
- Follow company processes for submission of corrected claims and appeals.
- Update insurance information and support primary, secondary, and tertiary billing.
- Adhere to compliance standards, including Code of Conduct and Conflict of Interest policies.
- Stay informed of federal and state regulations and company policies.
- Perform other related duties as assigned.
Requirements
Education
- High school diploma or equivalent.
Experience
- Minimum 2 years of medical billing and/or accounts receivable experience, preferably in behavioral health.
- Preferable experience in Arizona and/or Washington markets.
- Working knowledge of CMS guidelines, contracted insurance guidelines, and coding policies.
- Demonstrated computer skills.
Skills
- Detail-oriented, reliable, and able to multitask in a fast-paced, high-volume environment.
- Intermediate to advanced proficiency in Microsoft Excel.
- Excellent written and verbal communication skills, especially for telephone and in-person correspondence.
- Prior training experience preferred.
- Strong computer skills including databases, spreadsheets, and billing/coding/accounting software.
- Ability to analyze and interpret data, formulate and implement solutions.
- Adaptability to change and ability to work collaboratively in a diverse team.
- Critical thinking and problem-solving skills.
- Ability to provide guidance and feedback to others.
Miscellaneous
- Must be at least 18 years old (age requirements may vary by state).
- Ability to maintain confidentiality in accordance with HIPAA guidelines.
- Valid driver’s license required.
- Must pass a seven-year background check, substance abuse testing, education verification, fingerprinting clearance (if applicable), and motor vehicle report check (if driving is required).
- Travel may be required based on business needs.
Driving Requirements
- If driving is required, must meet all company driving policy requirements.
- If not qualified to drive, a Non-Driver Attestation form must be signed.
Physical Demands
- Frequent sitting, standing, walking, handling, finger dexterity, eye-hand-foot coordination.
- Use of corrected vision and color vision.
- May be required to lift up to 20 pounds.
Work Environment
- May work in an office environment or behavioral health facility.
- May have contact with individuals who are agitated or confused.
- Work may include travel within the geographic region.
Location
Remote work with residency required in one of the following states: Arizona, Delaware, Florida, Louisiana, Massachusetts, Maryland, Michigan, North Carolina, Ohio, Oregon, Pennsylvania, Tennessee, Texas, Utah, or Washington.
Compensation & Benefits
- Hourly wage: $23.50/hr.
- Comprehensive benefits package including health, dental, and vision insurance.
- Access to mental health resources and wellness programs.
- Retirement plan with company matching.
- Generous paid time off.
- Opportunities for professional development and training.
Additional Notes
- This employer is a second-chance employer and evaluates all qualified applicants fairly, including those with criminal histories, in accordance with legal and funder requirements.
- Reasonable accommodations are available for individuals with disabilities during the application and recruiting process.
- Age requirements may vary by state; for example, candidates must be 21 or older in Arizona and 24 or older in Louisiana.