RCM PreProcess Specialist — In-Office, Growth Ready

VaxCare; Orlando (FL); On-site; USD 28,000 - 41,000; Full time

Job summary

VaxCare is seeking a motivated RCM Operations, PreProcess Specialist to join our in-office Core Ops team. The role focuses on pre-submittal for claims processing, directing the workflow for claim submissions, and resolving payer rejections to ensure accepted statuses.

You will work with external payer portals to verify patient eligibility and process claims through the clearinghouse, driving timely reimbursements and process improvements.

Qualifications

• Critical thinkers who are willing to research and solve problems.
• Eagerness to learn the industry and position to grow within VaxCare.
• Aptitude and motivation.
• Proficient in Excel (Pivot Tables, Formulas and Charts).
• Good tenure of consistent experience.
• Candidates with prior Healthcare Insurance Claims experience are preferred.

Responsibilities

• Meet daily metrics related to quality and quantity of work as assigned.
• File claim corrections using web-based applications and bring claims to a final state of resolution promptly.
• Investigate what factors contribute to claims not being accepted by the clearinghouse, and make changes to achieve that.
• Collaborate with your team to create and implement enhanced collection techniques based on experience, data, and analytics

Skills

Critical thinking

Willingness to learn

Motivation

Excel (Pivot Tables/ Formulas)

Healthcare claims experience

Experience/tenure

Job description

VaxCare is seeking a motivated RCM Operations, PreProcess Specialist to join our in-office Core Ops team. The role focuses on pre-submittal for claims processing, directing the workflow for claim submissions, and resolving payer rejections to ensure accepted statuses.

You will work with external payer portals to verify patient eligibility and process claims through the clearinghouse, driving timely reimbursements and process improvements.