RCM Billing Claims Specialist- Medical Accounts Receivable Experience

Netsmart; United States; Remote; USD 40,000 - 80,000; Full time

Job summary

An innovative firm is seeking a detail-oriented Accounts Receivable Specialist to enhance client performance through effective medical billing practices. In this role, you will be responsible for resolving outstanding balances, analyzing denial trends, and utilizing automation tools to streamline processes. The ideal candidate will possess strong analytical and communication skills, along with a solid understanding of insurance policies and billing requirements. Join a dynamic team dedicated to improving healthcare revenue cycles in a supportive remote work environment.

Qualifications

• 1+ years of medical billing and accounts receivable experience.
• Advanced Excel skills including vlookups and pivot tables.

Responsibilities

• Gather reimbursement on client accounts and identify denial trends.
• Contact insurance companies to resolve claim processing issues.

Skills

Medical Billing Experience

Accounts Receivable Experience

Advanced Microsoft Excel

Analytical Skills

Problem-Solving Skills

Communication Skills

Understanding of Insurance Policies

Education

High School Diploma or GED

Tools

RPA Tools

AI-Powered Revenue Cycle Management Systems

Medical Billing Systems (Medic, IDX, Avatar, Tier, Medical Manager)

Job description

Responsible for researching and resolving outstanding balances by following up on claim status, working denials, and filing appeals.

Responsibilities

• Gather accurate reimbursement on client accounts and identify denial trends to improve client performance

• Contact insurance companies by phone, email, fax, and written correspondence to resolve issues that prevent claims from being processed correctly

• Follow up on outstanding medical A/R with no response from the insurance carriers

• Review and apply current standards on federal and state regulations and statues that influence collections of receivables and meet productivity standards

• Utilize RPA tools and AI-assisted workflows to automate routine claim follow-up tasks and enhance processing efficiency

• Handle Electronic Data Interchange (EDI) transactions, including reconciling carrier submissions, edits and rejection reports

Qualifications
Required

• High school diploma or GED.

• At least 1 year of medical billing experience.

• At least 1 year of Accounts Receivable experience

• Advanced Microsoft Excel skills including vlookups, pivot tables, and spreadsheet management

• Strong analytical and problem-solving skills

• Excellent verbal and written communication skills

• Demonstrated ability to meet productivity metrics

• Basic understanding of insurance policies, Medicare, and Medicaid billing requirements

Preferred

• Knowledge of medical billing specifically in behavioral, homecare, or long-term care insurance.

• Collections experience in a healthcare setting.

• Working knowledge of medical billing systems such as Medic, IDX, Avatar, Tier, Medical Manager

• Experience with or willingness to learn automation tools and AI-powered revenue cycle management systems

Expectations

• Comfortable with remote work arrangements and virtual collaboration tools

• Physical demands include extended periods of sitting, computer use, and telephone communication

Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all individuals. We celebrate diversity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.

Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmart’s sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the individual can provide proof of valid prescription to Netsmart’s third party screening provider.

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All applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work visa sponsorship for this position.

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