RCM Denials & Reimbursement Specialist I

Gravity Diagnostics; Covington (KY); On-site; USD 42,000 - 56,000; Full time

Job summary

Gravity Diagnostics is seeking an RCM Specialist I to own the process of gathering and reviewing claim information to guarantee accurate and timely submissions. You’ll work closely with billing and clinical teams to resolve discrepancies and ensure reimbursement is maximized.

You will analyze denied claims, submit appeals, contact payers, and monitor accounts for underpayments while maintaining HIPAA compliance and high customer service standards.

Qualifications

• Excellent written and verbal communication required.
• Detail-oriented with strong organizational skills.
• Ability to work in a fast-paced environment.
• Analytical problem-solving abilities.
• Commitment to exceptional customer service.

Responsibilities

• Own the process of gathering and reviewing all claim information to guarantee accurate and timely submissions.
• Work closely with teammates across billing and clinical teams to obtain missing data or clarify any discrepancies.
• Analyze denied and rejected claims to identify the root cause and correct errors efficiently.
• Submit appeals and adjustments that maximize reimbursement in accordance with insurance guidelines.
• Reach out to payers directly to resolve outstanding claims, update information, and advocate for prompt payment.
• Follow up on underpaid or unpaid claims and ensure we’re capturing every dollar we deserve.
• Monitor accounts for credit balances and process timely, compliant refunds.
• Spot trends—share patterns of denials or delays with leadership so we can proactively tackle recurring issues.
• Keep your knowledge sharp as you stay up to date on payer policies, coding changes, and lab‑specific regulations.
• Safeguard patient information and ensure HIPAA compliance in every interaction.

Skills

Communication skills

Attention to detail

Analytical mindset

Customer service orientation

Microsoft Office proficiency

Billing platforms familiarity

Claims processes knowledge

Education

High school diploma or equivalent

Some college coursework preferred

Tools

TELCOR

Electronic billing systems

Job description

Gravity Diagnostics is seeking an RCM Specialist I to own the process of gathering and reviewing claim information to guarantee accurate and timely submissions. You’ll work closely with billing and clinical teams to resolve discrepancies and ensure reimbursement is maximized.

You will analyze denied claims, submit appeals, contact payers, and monitor accounts for underpayments while maintaining HIPAA compliance and high customer service standards.