RCM Coordinator

Sciometrix•Somerset, NJ

1d•Onsite

About The Position

At Sciometrix, our goal is to deliver the best-ever personalized care with utmost compassion enabling patients to lead healthier and happier lives. Our commitment to innovation in healthcare technology drives us to lead the way in Care Management, Digital Care Coordination, Value-Based Care, and Population Health. We envision a world where advanced technology and human compassion intersect seamlessly to deliver superior patient experiences and outcomes. Our mission is to enhance the lives of patients by leveraging digital solutions that reduce hospital readmissions, improve health outcomes, and optimize the delivery of healthcare services. At the heart of our philosophy lies the belief that every patient deserves access to the highest quality of care, tailored to their individual needs. We strive to make this vision a reality by pioneering innovative solutions that prioritize patient well-being and provider efficiency. With Sciometrix, the future of healthcare is not just about treating illnesses; it's about empowering patients to live their best lives.

Requirements

High school diploma or equivalent required; Associate's degree in healthcare administration, business, or related field preferred.
4–6 years of experience in medical billing, revenue cycle, or healthcare administrative coordination (telehealth or outpatient setting a plus).
Working knowledge of ICD-10, CPT, and HCPCS coding concepts, and payer billing requirements (Medicare, Medicaid, Commercial, CCM, RPM).
Proficiency with EMR/EHR and practice management/billing software, plus strong Microsoft Office/Outlook skills.
Excellent written and verbal communication skills; comfortable managing high email and phone volume and cross-team follow-up.
Strong organizational skills and attention to detail in a deadline-driven RCM environment.
Ability to multitask, prioritize, and track multiple open items to resolution.

Nice To Haves

Coding or billing certification (CPC, CBCS, CMAA, or similar) a plus, though not required for this coordinator-level role.
Experience with denial management, AR follow-up, or pre-billing audit workflows.
Familiarity with telehealth-specific billing models (CCM, RPM, virtual visits).
Strong analytical and problem-solving skills; comfortable working independently and collaboratively.

Responsibilities

Monitor and manage the shared RCM/billing mailbox daily — triage payer correspondence, denial notices, patient billing inquiries, and internal requests, routing each to the right team member and responding within SLA.
Serve as the first point of contact for coding, billing, and collections questions from internal clinical and administrative staff.
Coordinate communication between coders, billers, physicians, nurse practitioners, and payers to resolve documentation gaps or claim holds.
Maintain and update trackers/logs (claims in process, denials, pending documentation, escalations) and share status updates with the RCM Manager.
Make outbound calls to patients to verify insurance coverage and update account information as needed.
Track claims through the full billing cycle — submission, clearinghouse acceptance, payer adjudication, denial/appeal, and payment posting.
Review claim edits, rejections, and clearinghouse reports; route corrections to the appropriate coder or biller and follow up to closure.
Support timely charge entry and claims submission by confirming encounters, documentation, and coding are complete and ready for billing.
Assist with insurance verification, eligibility checks, and prior authorization tracking as needed.
Help prepare and distribute daily/weekly RCM reports (claims submitted, denials, AR aging, first-pass acceptance rate).
Log and categorize denials, identify trends, and escalate recurring issues to coding, billing, or payer contacts.
Support timely appeals by gathering documentation, correcting claims, and coordinating resubmission with the billing team.
Follow up on aged accounts receivable and outstanding payer balances, documenting all activity in the practice management/EHR system.
Ensure all coordination activities comply with HIPAA, CMS, and payer-specific telehealth billing guidelines.
Identify workflow bottlenecks and recommend process improvements to reduce denials and improve first-pass acceptance rate (FPAR).
Maintain accurate, organized documentation and audit trails to support pre-billing and compliance reviews.
Stay current on payer policy changes, telehealth regulations, and RCM industry best practices.