RCM Specialist

- Execute all assigned RCM tasks in line with best practices and internal standard operating procedures - Conduct accounts receivable follow-up to address unpaid or underpaid claims, denials, and aged balances through appropriate methods such as appeals and corrections - Audit accounts to confirm accurate claim submission, payment applications, and the resolution of outstanding balances - Examine and resolve credit balances; process refunds to patients and insurance in adherence to regulations and internal policies - Accurately post all insurance and patient payments in a timely manner, including zero-dollar payments and remittance reconciliation - Implement adjustments and write-offs according to payer contracts and internal guidelines - Regularly review accounts receivable aging reports to minimize the days in AR and the percentage of AR over 90 days - Maintain clear documentation of account activities, interactions with payers, and refund processing procedures - Collaborate with internal teams, such as billing and front office, to ensure proper claims and rapid issue resolution - Uphold compliance with HIPAA, payer guidelines, and internal regulations - Participate in team meetings to discuss performance metrics, workflow improvements, and process enhancements - Assist RCM management in understanding and identifying factors impacting site-specific RCM KPIs, emphasizing areas needing attention and improvement