RCM Specialist III

Health Choice Network, Inc.; Northern (KY); Hybrid; USD 50,000 - 60,000; Full time

Benefits offered by this job

100% Remote Work

100% Employer-Paid Medical Insurance

Annual $1,500 HSA Contribution

Generous PTO

403(b) Retirement Plan with Employer**

Professional Development & Education

Disclaimer

Job summary

Health Choice Network, Inc. is seeking a RCM Specialist III to support medical billing, insurance follow-up, and denial management from a fully remote role in the United States. You will handle claims, eligibility checks, and AR while maintaining high service standards.

Ideal candidates have 2–3 years in medical billing with Medicare/Medicaid experience, strong communication, and the ability to manage multiple priorities in a fast-paced environment.

Qualifications

• Minimum of 2-3 years of medical billing, insurance collections, accounts receivable, or denial management.
• Experience with Medicare, Medicaid, and commercial payers.
• Knowledge of medical terminology, billing guidelines, and regulations.
• Strong analytical, organizational, and problem-solving skills.
• Excellent verbal and written communication skills.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
• Ability to work independently while collaborating with a team.

Responsibilities

• Prepare and submit clean claims to insurance carriers electronically and on paper when needed.
• Review claims for accuracy and correct billing or coding issues for rebilling or secondary billing.
• Research and resolve claim rejections, holds, denials, and payment variances.
• Verify patient eligibility, benefits, and insurance coverage.
• Follow up with insurers on unpaid/underpaid claims to ensure timely reimbursement.
• Maintain compliance with payer guidelines and billing requirements.
• Research outstanding AR and correct patient demographics, insurance data, provider data, claim details.
• Assist with patient collections and deposit reconciliation activities.
• Document all account activity and communications in the system.
• Monitor aging AR and identify opportunities to improve collection performance.
• Communicate professionally with patients, providers, insurers, and internal stakeholders.
• Provide excellent customer service while resolving billing inquiries.
• Collaborate with Revenue Cycle Management team for efficiency.
• Cross-train across RCM functions and support billing operations.

Skills

Analytical

Organizational

Problem-solving

Verbal communication

Written communication

Multitasking

Independence

Team collaboration

Education

High School Diploma or GED

Tools

EMR System (EPIC)

Electronic Medical Records (EMR)

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

RCM Specialist III

Regular Full-Time Professional Remote, US

Salary Range: $50,000.00 To $60,000.00 Annually

Are you an experienced medical billing professional who thrives on solving complex claim issues and driving revenue cycle performance? We're looking for a Billing & Collections Specialist to join our team and play a key role in ensuring timely and accurate reimbursement while supporting exceptional service for our health centers and patients.

If you're detail-oriented, customer-focused, and experienced in medical billing, insurance follow-up, denial management, and account resolution, we'd love to hear from you.

What You'll Do

• Prepare and submit clean claims to insurance carriers electronically and via paper as needed.
• Review claims for accuracy and identify billing or coding issues requiring corrections, rebilling, or secondary billing.
• Research and resolve claim rejections, holds, denials, and payment variances.
• Verify patient eligibility, benefits, and insurance coverage.
• Follow up with insurance carriers regarding unpaid and underpaid claims to ensure timely reimbursement.
• Maintain compliance with payer guidelines and billing requirements.

Accounts Receivable & Collections

• Research outstanding accounts receivable and initiate corrections related to patient demographics, insurance information, provider data, claim details, and modifiers.
• Assist with patient collections and deposit reconciliation activities.
• Accurately document all account activity, communications, and transactions within patient accounts.
• Monitor aging accounts and identify opportunities to improve collection performance.
• Communicate professionally with patients, providers, insurance carriers, and internal stakeholders via phone, email, and written correspondence.
• Provide exceptional customer service while resolving billing and payment inquiries.
• Collaborate with Revenue Cycle Management team members to ensure operational efficiency.
• Cross-train and provide support across Revenue Cycle functions, including payment posting, reconciliation, customer service, and billing operations.

Process Improvement & Operational Support

• Identify billing trends, recurring issues, and opportunities for process improvement.
• Support departmental initiatives designed to improve claim accuracy, cash collections, and reimbursement outcomes.
• Adapt to changing business needs and perform additional responsibilities as assigned.

Required Qualifications

• High School Diploma or GED.
• Minimum of 2-3 years of experience in medical billing, insurance collections, accounts receivable, or denial management.
• Experience working with Medicare, Medicaid, and commercial insurance payers.
• Knowledge of medical terminology, insurance guidelines, and billing regulations.
• Strong analytical, organizational, and problem-solving skills.
• Excellent verbal and written communication skills.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.
• Ability to work independently while maintaining a collaborative team approach.

Preferred Qualifications

• Experience working within an Electronic Medical Record (EMR) system.
• EPIC experience and/or certification.
• Experience with denial management, insurance follow-up, and revenue cycle operations.

Why Join Us?

At our organization, you'll have the opportunity to support a mission focused on improving community health while helping ensure the financial health of the health centers we serve. Your expertise will play a critical role in optimizing revenue cycle performance, improving operational efficiency, and supporting access to quality healthcare services.

What We Offer

100% Remote Work – Work from anywhere within the United States.

100% Employer-Paid Medical Insurance – Comprehensive medical coverage at no cost to employees on one of our health plans.

Annual $1,500 HSA Contribution – Additional support to help manage healthcare expenses.

Generous Paid Time Off (PTO) – Take the time you need to rest, recharge, and maintain work-life balance.

403(b) Retirement Plan with Employer Contribution – Invest in your future with retirement savings support.

Professional Development & Education Assistance – Grow your skills through ongoing learning, certifications, and educational opportunities.

Disclaimer

At this time, Health Choice Network is not able to employ individuals who reside or work in California. Applicants must reside and perform work in an approved state at the time of hire and throughout employment.