RCM Data & Claims Specialist

Ensora Health; Alabama; On-site; USD 42,000 - 65,000; Full time

Job summary

Ensora Health is seeking an detail-oriented RCM Specialist II to manage accounts receivable and resolve complex billing challenges in a fast-paced environment. You will collaborate with clinicians, practice owners, and customers to ensure accurate claims processing and timely cash collection.

The role emphasizes proactive account management, data-driven decision making, and continuous improvement to optimize reimbursement outcomes in behavioral health billing contexts.

Qualifications

• Associate degree or equivalent combination of education and experience.
• Minimum of 1 year of medical billing or revenue cycle management experience.
• Minimum of 1 year of customer service, account management, or client-facing experience.
• Strong understanding of insurance billing, behavioral health billing, and therapy reimbursement processes.
• Working knowledge of the healthcare revenue cycle, including claims submission, payment posting, denial management, appeals, and accounts receivable follow-up.

Responsibilities

• Submit, review, correct, and process denied, rejected, and unpaid insurance and healthcare claims with a focus on accuracy and timely resolution.
• Research and resolve claim issues by identifying root causes, recommending solutions, and collaborating with internal and external stakeholders.
• Effectively prioritize and manage a high-volume workload based on claim age, complexity, customer impact, and urgency.
• Own the accounts receivable process for assigned accounts, leveraging reporting, analytics, and account reviews to monitor performance and identify opportunities for improvement.
• Partner closely with clinicians, practice owners, and customers to provide proactive account management and exceptional service.
• Build trusted relationships through regular meetings, strategic account discussions, written correspondence, and ongoing communication.
• Identify trends, denials, and reimbursement challenges while recommending process improvements that enhance operational efficiency and customer outcomes.
• Utilize technology and available tools to streamline workflows, improve productivity, and support data-driven decision making.
• Collaborate with team members, Leads, and Managers to share knowledge, solve complex issues, and contribute to a culture of continuous improvement and service excellence.
• Stay current on payer requirements, industry changes, and revenue cycle best practices to support customer success.
• Perform other duties as assigned.

Skills

Medical billing

Revenue cycle management

Customer service

Account management

Data analysis

Education

Associate degree or equivalent

Tools

Billing systems

Reporting tools

Microsoft Office

Job description

Ensora Health is seeking an detail-oriented RCM Specialist II to manage accounts receivable and resolve complex billing challenges in a fast-paced environment. You will collaborate with clinicians, practice owners, and customers to ensure accurate claims processing and timely cash collection.

The role emphasizes proactive account management, data-driven decision making, and continuous improvement to optimize reimbursement outcomes in behavioral health billing contexts.