RCM AR Specialist

RCM AR Specialist follows up on denied claims and overdue insurance balances using EOBs and payer communications; assigned to a specific book of business based on Financial Class and Payers; works to support field-related claim denials. Responsibilities include submitting appeals related to contract rate variances, submitting Medical Records when requested by the payer, monitoring payer correspondence, responding to inquiries, contacting payers about aged claims (45+ days), maintaining knowledge of practice management software, communicating with insurance companies, meeting with Pod Lead/Supervisor to discuss reimbursement concerns, attending meetings and continuing education, and performing additional duties as requested by RCM Leadership. Qualifications include familiarity with Explanation of Benefits, CPT/ICD-10 coding, managed care/Medicare/Medicaid reimbursement, strong written and verbal communication, and comfort with email and internet applications.