RCM Collections Specialist: Claims Recovery & Denials

KPH HEALTHCARE SERVICES, INC; Hoffman Estates (IL); On-site; USD 48,000 - 68,000; Full time

Job summary

KPH HEALTHCARE SERVICES, INC. is seeking a Revenue Cycle Management professional to manage collections for outstanding claims and work with insurance companies, patients, and other parties to resolve issues.

The role emphasizes denial resolution, appeals, and maintaining precise records to support company-wide revenue cycle improvements. You will collaborate with internal teams to address challenges, escalate complex cases, and ensure compliance with regulatory standards.

Responsibilities

• Manage the collection process for outstanding claims with contact via phone, email, and written correspondence.
• Investigate and resolve denied or partially paid claims, identifying root causes and corrective actions.
• Collaborate with internal teams to address claims challenges and improve revenue cycle.
• Escalate complex or uncollectible accounts to management for further action.
• Submit appeals/claim corrections within timely filing limits.
• Utilize billing software to maintain accurate records of all collection activities with payers and patients.
• Identify and report trends in claim denials and payment challenges.
• Communicate with patients about billing issues and responses to financial hardship applications.
• Support accurate record-keeping to keep information up-to-date across departments.
• Assist in implementing processes to measure and improve RCM performance.
• Ensure compliance with laws, accreditation standards, and best practices; participate in surveys and committees.

Job description

KPH HEALTHCARE SERVICES, INC. is seeking a Revenue Cycle Management professional to manage collections for outstanding claims and work with insurance companies, patients, and other parties to resolve issues.

The role emphasizes denial resolution, appeals, and maintaining precise records to support company-wide revenue cycle improvements. You will collaborate with internal teams to address challenges, escalate complex cases, and ensure compliance with regulatory standards.