RCM Specialist / Certified Professional Coder (CPC)
$50,960–$53,040 year
RemoteUnited States
Job Summary
Verify patient eligibility and benefits, identify and resolve claims processing issues including pre-submission errors, and generate appeals or reprocess claims as needed. Contact insurance payers for eligibility, claims resolution, and authorization requests while communicating effectively with patients, physicians, management, and third-party representatives. Submit medical records to insurance when needed and review and audit patient accounts for accuracy. Manage a high volume of claims, calls, chats, and tasks while meeting productivity and quality standards. Respond promptly to all calls, chats, and voicemails during business hours. Maintain compliance with professional standards, company policies, and federal, state, and HIPAA regulations.
Required Qualifications
- Certified Professional Coder or Biller (CPC / CPB)
- 1-2 years previous Medical Billing experience
- Must be able to work independently and rely on personal knowledge/experience for problem-solving
- Must have experience with MS Word and Google Sheets or MS Excel
- Must be detail-oriented and have excellent organizational and time management skills
- Requires strong analytical skills and attention to detail, including writing and verbal communication skills and a professional positive attitude
- Experience in calling health insurance plans
Desired Qualifications
- Experience billing for addiction medicine and/or outpatient medication-assisted treatment
- Experience in billing for telemedicine services
- Payment Posting
- Proficient in medical software, insurance websites, and EHR systems (Elation or Candid preferred)
- Candidates will demonstrate patient and empathetic communication to our members
- Candidates will be able to work accounts promptly
- Candidates will be open to workflow changes
- Candidates must excel at providing a high level of customer service and be able to work in a team environment
- Candidates will maintain a positive and optimistic attitude
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