Remote RCM Specialist I: Insurance & Claims

Remote Jobs; Lincoln (NE); Remoto; USD 38.000 - 58.000; Tempo integral

Resumo da vaga

Remote Jobs is seeking a RCM Specialist I to support front-end and mid-cycle revenue cycle tasks with a focus on insurance verification, claim submission, and patient service. You will verify eligibility, gather benefits, and ensure clean claims while maintaining HIPAA compliance.

The role emphasizes attention to detail, strong communication with payers and patients, and collaboration with the RCM team to optimize KPIs such as days in AR and net collections.

Qualificações

• Experience in dental office workflows and revenue cycle functions including scheduling, registration, insurance verification, and claim submission.
• Knowledge of reimbursement/compliance with all payors.
• Experience with practice management software, insurance portals, clearing houses; proficient in MS Office and Excel; strong math and problem-solving; data entry by touch.
• Strong interpersonal and organizational skills; able to work in a team or as an individual contributor.
• Attention to detail; quality work, meeting deadlines and adherence to compliance and revenue cycle SOPs.
• Certified credentials (CPC or CRCP) preferred.

Responsabilidades

• Perform RCM activities per SOPs and best practices.
• Verify insurance coverage and benefits for scheduled patients via payer portals or calls.
• Enter and update insurance information in the practice management system.
• Confirm eligibility, plan limitations, and coordination of benefits for clean claims.
• Prepare and submit pre-determinations and pre-authorizations with attachments; monitor status.
• Submit claims (electronic, paper, or portal) per payer requirements and timelines.
• Review rejected claims, re-submit corrected claims as needed.
• Respond to patient/office inquiries regarding billing and balances.
• Assist in sending patient statements and follow up on outstanding balances.
• Document verification results, submissions, and patient interactions clearly.
• Escalate issues to RCM team if delays or system errors occur.
• Maintain HIPAA compliance and follow payer guidelines and SOPs.
• Participate in meetings to stay current on processes and updates.
• Support other RCM functions to ensure smooth revenue cycle operations.
• Assist management in analyzing site-specific RCM KPIs and opportunities for improvement.

Conhecimentos

Insurance verification

Claim submission

Customer service

HIPAA compliance

Attention to detail

Data entry

MS Office / Excel

Ferramentas

Practice management software

Insurance portals

Clearing houses

Descrição da vaga

Remote Jobs is seeking a RCM Specialist I to support front-end and mid-cycle revenue cycle tasks with a focus on insurance verification, claim submission, and patient service. You will verify eligibility, gather benefits, and ensure clean claims while maintaining HIPAA compliance.

The role emphasizes attention to detail, strong communication with payers and patients, and collaboration with the RCM team to optimize KPIs such as days in AR and net collections.