Hybrid RCM AR Specialist: Claims, Denials & KPI Focus

Veradigm Inc.; Raleigh (NC); Hybrid; USD 45,000 - 60,000; Full time

Benefits offered by this job

Hybrid work arrangement

Equal employment opportunity

Job summary

Veradigm Inc. is seeking an Accounts Receivable Specialist to optimize AR recovery for RCMS clients. This hybrid role focuses on researching medical claims, preparing appeals, and interacting with insurance carriers to resolve claims and improve KPI results. No budget responsibilities but strict adherence to processes is required.

The position involves 2 days in the Raleigh office, with remote work flexibility as part of a hybrid arrangement, supporting RCMS Operations and Client Services.

Qualifications

• Experience with healthcare AR and insurance claims
• Proficiency with payer portals and medical coding basics
• Familiar with CPT, ICD-10 and modifiers
• Experience with MS Office and reporting tools

Responsibilities

• Manage accounts receivable recovery and KPI achievement
• Research and respond to insurance claim issues and appeals
• Handle payer denials and secondary claims processing
• Monitor and reconcile claims, vouchers, denials and credits
• Provide timely communication with clients, patients and carriers

Skills

Customer service

Claims processing

Payer denials

Microsoft Office

Allscripts PM

NextGen

Epic

Tools

MS Access

PowerPoint

Crystal Reports

Laserfiche

SharePoint

Job description

Veradigm Inc. is seeking an Accounts Receivable Specialist to optimize AR recovery for RCMS clients. This hybrid role focuses on researching medical claims, preparing appeals, and interacting with insurance carriers to resolve claims and improve KPI results. No budget responsibilities but strict adherence to processes is required.

The position involves 2 days in the Raleigh office, with remote work flexibility as part of a hybrid arrangement, supporting RCMS Operations and Client Services.