RCM Billing Claims Specialist- Medical Accounts Receivable Experience

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

Job summary

An established industry player is seeking a detail-oriented individual to join their team in a remote role focused on medical billing and accounts receivable management. This position involves researching outstanding balances, contacting insurance companies, and utilizing automation tools to enhance efficiency. Ideal candidates will have experience in medical billing, strong analytical skills, and proficiency in Microsoft Excel. Join a forward-thinking organization committed to diversity and a drug-free workplace, where your contributions will help improve client performance and streamline operations.

Qualifications

• 1+ years of experience in medical billing and accounts receivable.
• Advanced skills in Microsoft Excel for data management.

Responsibilities

• Resolve outstanding balances and improve client performance.
• Contact insurance companies to resolve claims processing issues.

Skills

Medical Billing Experience

Accounts Receivable Experience

Microsoft Excel (vlookups, pivot tables)

Analytical Skills

Communication Skills

Understanding of Insurance Policies

Education

High School Diploma or GED

Tools

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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