Revenue Cycle Claims Specialist

Qualderm; United States; Hybrid; USD 27,000 - 38,000; Full time

Benefits offered by this job

Competitive Pay

Comprehensive Health Coverage

Generous 401(k) Plan

Paid Time Off (PTO)

Company-Paid Life Insurance

Disability Protection

Wellness Plans

Employee Assistance Program (EAP)

Exclusive Employee Discounts

Referral Bonus Program

Job summary

QualDerm Partners is seeking a Revenue Cycle Specialist to identify and resolve third-party payer rejections and assist in ensuring accurate charge submissions across our dermatology network. The role collaborates with the coding team to enter charges in the EMR and resolve edits that affect payments.

You will monitor missing charges, analyze trends, and escalate issues to RCM leadership while maintaining timely communication with multiple departments.

Qualifications

• 1-3 years of medical billing/RCM experience in a physician practice or billing company.
• Completion of Modernizing Medicine University courses within 6 months of hire.
• Excellent verbal and written communication and attention to detail.

Responsibilities

• Manage claims returned which have failed scrub rules
• Identify and resolve payer rejections in a timely manner
• Enter charges/bills into EMR in coordination with certified coding team/Coding manager
• Monitor missing charges and communicate with RCM management as needed
• Must have knowledge of claim correction, electronic claim submission
• Ability to contact payers when necessary to resolve any issues
• Report any trends in a timely manner to RCM leadership that prevent successful claim submission
• Ability to effectively communicate with other departments such as Coding, AR/Follow-up, Patient Services and Posting

Skills

Payer rejections resolution

EMR data entry

Attention to detail

Excel data analysis

Team collaboration

Tools

MS Excel

EMR system

Billing software

Modernizing Medicine University courses

Job description

QualDerm Partners is seeking a Revenue Cycle Specialist to identify and resolve third-party payer rejections and assist in ensuring accurate charge submissions across our dermatology network. The role collaborates with the coding team to enter charges in the EMR and resolve edits that affect payments.

You will monitor missing charges, analyze trends, and escalate issues to RCM leadership while maintaining timely communication with multiple departments.