RCM Specialist II
RCM Specialist II
Posted on :
22-06-2025
Employer Active
1 Vacancy
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Monthly Salary
Not Disclosed
Salary Not Disclosed
Vacancy
1 Vacancy
Posted on :
22-06-2025
Job Description
RCM Specialist II
Department: Revenue Cycle Management
Reports to: Senior Manager of Revenue Cycle
Pay Group: Non-Exempt
Do you love solving puzzles and making processes work better Join our team as an RCM Specialist II where youll play a vital part in ensuring our laboratory services are reimbursed fully and on time. Youll dive into denied and rejected insurance claims identify the causes and drive resolutions that help support our mission of delivering exceptional care.
Your knack for research collaboration and follow-through will help streamline the revenue cycleand your contributions will make a real impact!
What Youll Do
- Own the process of gathering and reviewing all claim information to guarantee accurate and timely submissions.
- Work closely with teammates across billing and clinical teams to obtain missing data or clarify any discrepancies.
- Analyze denied and rejected claims to identify the root cause and correct errors efficiently.
- Submit appeals and adjustments that maximize reimbursement in accordance with insurance guidelines.
- Reach out to payers directly to resolve outstanding claims update information and advocate for prompt payment.
- Follow up on underpaid or unpaid claims and ensure were capturing every dollar we deserve.
- Monitor accounts for credit balances and process timely compliant refunds.
- Spot trendsshare patterns of denials or delays with leadership so we can proactively tackle recurring issues.
- Keep your knowledge sharp as you stay up to date on payer policies coding changes and lab-specific regulations.
- Safeguard patient information and ensure HIPAA compliance in every interaction.
What Were Looking For
- Excellent communication skills (both written and verbal)
- Super strong attention to detail and organization
- Ability to thrive in a fast-paced fast changing environment
- Analytical mindset and problem-solving drive
- Commitment to exceptional customer service
- Proficiency with Microsoft Office and other electronic health or billing platforms
- Familiarity with claims processes coding basics and industry-specific best practices
Preferred Qualifications
- Prior experience handling claims denials and appeals
- Medical coding certification or lab industry background preferred
- Familiarity with TELCOR and electronic billing systems
- 2 years of claims processing and/or relevant certification (e.g. CRCR CPC)
- High school diploma or equivalent required; some college preferred
Physical Requirements
- Extended periods of sitting and computer use
- Extended periods of talking listening and typing while on a phone
Why Join Us
Youll be part of a collaborative supportive team committed to improving healthcare every day. This is a place where your expertise truly matters we cant wait for you to grow with us!
Youll be part of a collaborative supportive team committed to improving healthcare every day. This is a place where your expertise truly matters we cant wait for you to grow with us!
Gravity Diagnostics is an Equal Opportunity Employer. All persons shall have the opportunity to be considered for employment without regard to their race color religion national origin ancestry alienage or citizenship status age sex gender gender identity gender expression sexual orientation marital status disability military service and veteran status pregnancy childbirth and related medical conditions or any other characteristic protected by applicable federal state or local laws.
Gravity Diagnostics will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business.
Required Experience:
Unclear Seniority
Employment Type
Full Time
Key Skills
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