RCM Billing Specialist – Part Time

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee tasks associated with third-party payer billing

• Confirm benefits and secure authorizations

• Submit claims accurately and punctually

• Ensure compliance of claims with federal, state, and payer regulations

• Analyze payer explanations of benefits (EOBs) to guarantee proper reimbursement

• Report billing issues, challenges, and payer trends to management

• Utilize payer web portals to identify reasons for front-end denials and rectify and resubmit claims

• Conduct insurance reverification and initiate billing to a new payer, reprocess claims, or bill patients as necessary

• Handle third-party payer correspondence, refunds, and adjustments

• Remain updated on payer informational notices and changes

• Share insights and suggestions for process improvements with the team

• Address patient inquiries promptly

• Achieve regular productivity targets while ensuring high quality

• Adhere to work instructions, policies, and behavioral expectations

• This position does not involve supervisory responsibilities

⛳️ Requirements

• Preferred Associate Degree or equivalent; minimum of two years of relevant experience; or a suitable combination of education and experience

• Desired experience related to Negative Pressure Wound Therapy

• Strong organizational skills

• Effective troubleshooting abilities

• Exceptional attention to detail

• Proficient in Word, Excel, and Outlook

• Ability to operate Express/HDMS/WayStar proficiently

• Knowledge of insurance guidelines, including Medicare, Medicaid, Workers Compensation, and commercial managed-care plans

• Capability to manage inquiries and respond via phone or in writing

• Skills to explain and resolve collection-related questions/issues for patients, sales representatives, and facilities

• Proper understanding of ICD-10, CPT, and HCPCS coding

• Ability to independently meet strict deadlines in a project-driven environment

• At least 2 years of medical experience

• A minimum of 1 year of customer service experience

• Ability to interpret payer explanations of benefits (EOBs)

• Experience with payer web portals and claims processing

• Understanding of DME and healthcare-related billing

• Strong written and verbal communication skills

• Proficient analytical thinking and problem-solving abilities

• Capability to work collaboratively as part of a team

🏝️ Benefits

• Reasonable accommodations may be provided to enable individuals with disabilities to perform the essential functions of the job

• Feedback and educational opportunities will be offered to support professional growth and development

• Equal Opportunity Employer