Healthcare Revenue Cycle Management Specialist

We are seeking a detail-oriented and proactive RCM
professional to manage end-to-end healthcare revenue cycle operations, ensure
accurate billing, minimize claim denials, and support timely revenue
realization. The ideal candidate should have strong knowledge of insurance
processes, claims management, and healthcare practice management software.

Requirements

Key Responsibilities

• Manage
  the complete RCM workflow, including patient scheduling, insurance
  eligibility and benefits verification, pre-determinations (Pre-Ds), claims
  processing, payments, ERAs, denials, accounts receivable (AR),
  reconciliation, and patient follow-ups.
  
• Review
  payer guidelines, coverage history, service frequencies, benefit
  limitations, out-of-network (OON) benefits, and documentation to identify
  potential billing issues.
  
• Monitor
  appointments, claims, outstanding balances, payments, denials, and
  follow-ups while maintaining accurate records and resolving discrepancies
  across systems.
  
• Investigate
  complex account issues and coordinate with payers and clients to ensure
  timely resolution from initial verification to final account closure.
  
• Identify
  claim rejection and denial trends, follow up on unpaid or underpaid
  claims, and support timely resubmissions and appeals to minimize revenue
  loss.
  
• Maintain
  detailed account documentation, ensure compliance with payer requirements,
  and recommend process improvements to enhance billing accuracy and
  operational efficiency.
  

Required Software Knowledge

Hands-on experience with one or more of the following
platforms:

• Dentrix
  
• Dentrix
  Ascend
  
• TherapyNotes
  
• SimplePractice
  
• Headway