RCM Specialist I

Gravity Diagnostics•Covington, KY

44d

About The Position

Do you love solving puzzles and making processes work better? Join our team as an RCM Specialist I, where you'll play a vital part in ensuring our laboratory services are reimbursed fully and on time. You'll 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 cycle-and your contributions will make a real impact!

Requirements

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
High school diploma or equivalent required; some college preferred

Nice To Haves

Prior experience handling claims denials and appeals
Medical coding certification or lab industry background preferred
Familiarity with TELCOR and electronic billing systems

Responsibilities

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 we're capturing every dollar we deserve.
Monitor accounts for credit balances and process timely, compliant refunds.
Spot trends-share 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.

Benefits

You'll be part of a collaborative, supportive team committed to improving healthcare every day.
This is a place where your expertise truly matters - we can't wait for you to grow with us!

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