Revenue Cycle Claims Pro

Azalea Health; Valdosta (GA); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

Paid time off

Job summary

Azalea Health is seeking a Revenue Cycle Claims Specialist to manage the lifecycle of medical claims and ensure accurate, timely submission. You will work with clearinghouses, payers, and internal teams to reduce rejections and accelerate reimbursement, while maintaining HIPAA compliance and documenting claim activity.

The ideal candidate has 2+ years in progressive RCM billing and coding, CPC/CPB certification preferred, and strong analytical and customer service skills.

Qualifications

• Associates or Bachelors Degree preferred.
• CPC, CPB or equivalent highly preferred.
• Minimum 2 years' experience in progressive RCM billing and coding.
• Minimum of 1 year of customer service/client relations and employee training experience.
• Excellent computer skills with strong proficiency in web-based and SaaS applications.

Responsibilities

• Review and validate claims for accuracy, completeness, and compliance prior to submission.
• Ensure all required elements are present (coding, modifiers, authorizations).
• Submit claims through clearinghouses or payer portals in a timely manner.
• Maintain productivity benchmarks and KPI's for claim processing and submission.
• Review claim edits and scrubbing rules to identify errors before submission.
• Correct issues related to coding, modifiers, eligibility, or missing information.
• Monitor and resolve any clearinghouse edits and rejections; as well as payer rejection reports daily.
• Research and resolve rejected claims promptly to avoid delays in payment.
• Identify root causes of rejections and implement corrective actions.
• Track rejection trends and elevate systemic issues.
• Stay current on payer specific billing requirements, edits, and submission guidelines.
• Ensure all claims meet payer guidelines, regulatory requirements, and internal SOPs
• Maintain accurate documentation of claim activity and corrections.
• Identify recurring claim errors, rejection patterns, or workflow inefficiencies.
• Provide feedback to leadership and cross-functional teams to improve clean claim rates.
• Support onboarding of new clients or payers by ensuring proper claim setup and workflows.
• Effectively communicate directly with clients via tasks to help resolve claim related issues.
• Partner with internal teams to collaborate on resolving claim issues.
• Maintain HIPAA compliance when handling patient protected health information (PHI)

Skills

Attention to detail

Analytical thinking

Customer service

Proactive problem-solving

Education

Associates or Bachelor's Degree preferred

CPC, CPB or equivalent certification preferred

Tools

Clearinghouses

Payer portals

SaaS applications

Job description

Azalea Health is seeking a Revenue Cycle Claims Specialist to manage the lifecycle of medical claims and ensure accurate, timely submission. You will work with clearinghouses, payers, and internal teams to reduce rejections and accelerate reimbursement, while maintaining HIPAA compliance and documenting claim activity.

The ideal candidate has 2+ years in progressive RCM billing and coding, CPC/CPB certification preferred, and strong analytical and customer service skills.