RCM Accounts Receivable Specialist – Medical Billing Experience

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🔥 0 minutes ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

💰 Accounts Receivable

🚫👨‍🎓 No degree required

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Netsmart

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1973

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

Netsmart is a leading provider of comprehensive EHR solutions tailored for a wide range of care settings, especially in behavioral health, addiction treatment, autism, geriatrics, and intellectual and developmental disabilities. The company offers a range of software products that streamline operations, enhance care coordination, and promote value-based care across healthcare communities. In addition to EHRs, Netsmart provides technology solutions for care coordination, telehealth, population health management, and revenue cycle management, aiming to support the delivery of integrated and person-centered care. Their solutions are used in a variety of sectors including human services, post-acute care, and public health, making Netsmart a significant player in the healthcare technology industry.

📋 Description

• Manage a portfolio of outstanding insurance accounts receivable and resolve unpaid or underpaid claims • Perform end-to-end denial management, including researching denials, identifying root causes, submitting appeals, and securing reimbursement • Analyze denial patterns and reimbursement trends to identify process improvements and revenue recovery opportunities • Contact insurance carriers through phone, email, fax, payer portals, and written correspondence • Investigate and resolve claim edits, rejections, authorization issues, coding discrepancies, and payer-specific reimbursement concerns • Follow up on aged accounts and claims with no carrier response while maintaining productivity and quality standards • Use Microsoft Excel to track accounts, analyze payer trends, manage work queues, create reports, and maintain denial inventories • Use Microsoft Outlook for communications with payers, clients, and internal stakeholders • Review and apply federal, state, Medicare, Medicaid, and payer-specific billing regulations • Handle EDI transactions, including carrier submission reconciliation, clearinghouse edits, and rejection reports • Leverage RPA tools and AI-assisted workflows to automate routine follow-up activities and improve claim resolution • Maintain detailed documentation of account activity and claim resolution efforts

🎯 Requirements

• High school diploma or GED • Minimum of 1 year of healthcare accounts receivable, medical billing, or denial management experience • Experience researching and resolving insurance claim denials and payer reimbursement issues • Advanced Microsoft Excel skills, including VLOOKUPs/XLOOKUPs, Pivot Tables, filters, formulas, and spreadsheet management • Strong proficiency in Microsoft Outlook, including high-volume email communications and claim follow-up correspondence • Understanding of insurance reimbursement processes, claim adjudication, Medicare, Medicaid, and commercial payer requirements • Strong analytical, critical thinking, and problem-solving skills • Excellent verbal and written communication skills • Ability to manage productivity metrics and work independently in a fast-paced environment • All applicants must be legally authorized to work in the United States • Netsmart does not provide work visa sponsorship • Preferred: experience in behavioral health, post-acute care, home health, long-term care, specialty healthcare billing, collections, formal appeals, medical billing systems, automation tools, AI-enabled workflows, or revenue cycle technology • Preferred: 2+ years of insurance AR follow-up and denial management experience

🏖️ Benefits

• Pre-employment background check and drug screen provided at Netsmart’s sole expense • Equal employment and advancement opportunities • Inclusive workplace committed to diversity • Healthy and safe workplace