RCM Specialist
About The Position
KVC is seeking a detail-oriented and motivated Revenue Cycle Management (RCM) Specialist to support financial operations and help ensure accuracy and efficiency across billing, collections, payment posting, and accounts receivable processes. The position has a hybrid schedule, with work from home and an in-office commitment of three days per week. The specialist monitors accounts receivable, investigates payment and claim issues, submits claims and appeals, handles billing inquiries, supports payment plans and financial aid applications, and performs payment posting and reconciliation. The role collaborates with internal departments and payer contacts, maintains confidentiality and HIPAA compliance, and contributes to training and continuous improvement. KVC’s mission focuses on helping children, families, and communities thrive.
Requirements
- High school diploma or equivalent.
- Valid driver's license and auto insurance.
- At least one year of experience in healthcare financial services, customer service, claims processing, or medical billing.
- Proficiency with Microsoft Office applications.
- Strong organizational and time-management skills.
- Ability to adapt to changing priorities and processes.
- Commitment to accuracy and confidentiality.
- Initiative, accountability, and ownership of work.
- Ability to identify trends and recommend improvements.
- Team-oriented mindset and collaborative approach.
Nice To Haves
- Strong verbal and written communication skills.
- Proficiency in Microsoft Word, Excel, and Outlook.
- Excellent analytical and problem-solving abilities.
- Strong attention to detail and organizational skills.
- Ability to prioritize and manage multiple tasks in a fast-paced environment.
Responsibilities
- Monitor accounts receivable reports and ensure claims are paid according to contracted rates.
- Identify and report irregular insurance payments.
- Investigate and resolve credit balances, denials, and claim rejections.
- Submit appeals and corrected claims when necessary.
- Prepare and distribute monthly client statements.
- Respond to billing inquiries and provide customer service.
- Assist with financial aid applications and payment plan coordination.
- Stay informed about payer policy updates and changes.
- Develop relationships with payer representatives and provider relations contacts.
- Review accounts to ensure accurate and timely claim submission.
- Submit professional and institutional electronic claims and prepare and submit paper claims as needed.
- Create and follow up on invoices for single-case agreements.
- Perform charge entry and account maintenance.
- Collaborate with internal departments to obtain and verify account information.
- Download, scan, and maintain insurance remittance documentation.
- Perform daily cash management activities, including deposits and payment tracking.
- Review and verify adjudication details prior to posting.
- Post and reconcile payments, adjustments, and transfers.
- Use reporting tools to ensure posting accuracy and balance.
- Work with payer contacts to resolve payment questions and discrepancies.
- Maintain professionalism, confidentiality, HIPAA compliance, and adherence to company policies.
- Participate in ongoing training and professional development and support continuous improvement initiatives.
Benefits
- Hybrid work environment with three in-office days per week.
- Meaningful work that impacts lives.
- Collaborative and supportive team environment.
- Opportunities for professional growth and development.
- Comprehensive training and cross-training opportunities.
- Mission-driven culture.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
