RCM Medical Biller: Claims & Reimbursement Specialist

Facilitex; Manhattan (KS); Sur place; USD 42 000 - 65 000; Plein temps

Résumé du poste

Facilitex is seeking a Medical Biller to manage the full Revenue Cycle Management process, ensuring accurate billing, timely payments, and prompt resolution of discrepancies. The role requires strong knowledge of payer guidelines, eligibility verification, and collaboration with clinicians and management to optimize reimbursement.

The ideal candidate has 1+ year of medical billing experience, proficiency with EMR/Practice Management systems, and a proactive mindset to maintain HIPAA compliance

Qualifications

• 1+ years of medical billing experience.
• Strong knowledge of Revenue Cycle Management (RCM).
• Experience with payment posting, insurance follow-up, and AR.
• Familiarity with Medicare, Medicaid, and commercial carriers.
• Experience in EMR/Practice Management systems.
• Excellent analytical and teamwork skills.

Responsabilités

• Review, scrub, and submit professional and facility claims accurately and timely.
• Process electronic and paper claims through clearinghouses and insurance carriers.
• Post insurance and patient payments from ERAs, EOBs, EFTs, and manual payments.
• Manage Accounts Receivable (A/R) by following up on unpaid, underpaid, and denied claims.
• Research and resolve claim rejections, denials, and payment discrepancies.
• Prepare and submit corrected claims, reconsiderations, and appeals as needed.
• Work aging reports and claim work queues to ensure accounts are touched regularly and resolved promptly.
• Maintain familiarity with Medicare, Medicaid, Managed Medicaid, and commercial insurance carriers.
• Understand payer-specific billing rules, authorization requirements, timely filing limits, and reimbursement policies.
• Verify insurance eligibility and benefits when necessary.
• Review patient balances and ensure accurate patient billing.
• Identify billing trends and escalate recurring payer or workflow issues.
• Collaborate with coding, front desk, providers, and management to resolve billing issues affecting reimbursement.
• Ensure documentation supports claim submission and reimbursement requirements.
• Maintain accurate account notes and documentation for all billing activity.
• Meet departmental productivity, quality, and collection goals.
• Stay current on insurance regulations, billing requirements, and coding updates affecting reimbursement.

Connaissances

Medical billing

RCM knowledge

Payment posting

A/R follow-up

HIPAA compliance

Description du poste

Facilitex is seeking a Medical Biller to manage the full Revenue Cycle Management process, ensuring accurate billing, timely payments, and prompt resolution of discrepancies. The role requires strong knowledge of payer guidelines, eligibility verification, and collaboration with clinicians and management to optimize reimbursement.

The ideal candidate has 1+ year of medical billing experience, proficiency with EMR/Practice Management systems, and a proactive mindset to maintain HIPAA compliance