RCM AR Specialist

About the Role

Responsible for the overall recovery and management of accounts receivable to maximize collections for RCMS clients. This position involves detailed research and follow-up on medical insurance claims and the careful preparation of appeals and responses to interact with insurance carriers and resolve claims. Supports the RCMS BU's Operations and Client Services by driving the accounts receivable process and achieving KPI results.

Key Responsibilities

• Manage and track information requests to clients.
• Answer and resolve all incoming calls and requests in a timely manner.
• Monitor and reconcile claims, including:
• Held vouchers
• Unbilled vouchers
• Denial trends
• Patient balance report
• Credits and refunds
• Handle complex payer denials effectively.
• Ensure secondary claims are processed and paid.
• Timely management of unpaid claims through the use of the client’s office management/administrator, aging reports, correspondence, Clearinghouse and PM rejections, and SharePoint reference/maintenance.
• Complies with and enforces policies and procedures.
• Achieves goals set forth by RCM management regarding error-free work, transactions, processes, productivity, and compliance requirements. Specific goals include 1,400 accounts worked per month.
• May act as a partner for new hires to assist them in learning.
• Other duties as assigned.

Customer Service & Client Interaction

• Strong customer service skills for client satisfaction and client AR health.
• Answering client, patient, and carrier calls.
• Prompt return and follow-up to all interactions.
• Prompt response to requests for information.

Qualifications

None explicitly stated in the raw text.