RCM Specialist Level 2

Job Description

Job Description

Under the direct supervision of the RCM Manager, the RCM Specialist Level 2 manages the revenue cycle by tracking, and reviewing payments from insurance companies and patients to ensure accurate and timely reimbursement. They analyze denied or unpaid claims, initiate appeals, and resolve billing discrepancies, typically requiring knowledge of medical coding, insurance regulations, and billing software.

QUALIFICATIONS:

• Experience: Two years of experience in medical billing, coding, collections, or revenue cycle management with basic computer skills. REQUIRED
• Knowledge: Must be a high school graduate or equivalent; strong understanding of ICD-10, CPT, HCPCS codes, and insurance guidelines (commercial and government payers).
  Certification in Coding/Billing, orthopedic experience and EHR proficiency preferred.
• Technical Skills: Proficiency in electronic medical records (EMR) and medical billing software.
• Soft Skills: High attention to detail, strong communication, and analytical skills for identifying payment trends.

ESSENTIAL JOB FUNCTIONS:

• Following up on unpaid or denied claims with insurance companies to secure payment.
• Researching and appealing denied or rejected claims by submitting necessary documentation.
• Acting as a liaison between payers, patients, and providers to resolve discrepancies.
• Maintaining accurate records, monitoring AR aging, and adhering to federal and state healthcare regulations.
• Verify/update patient demographic and insurance information.
• Maintain confidentiality and privacy.

Michigan Orthopedic Center is a multi-physician surgical practice serving mid-Michigan since 1990. We are committed to providing state-of-the art, high quality orthopedic care and professional, compassionate patient experience. Our subspecialty fellowship trained surgeons treat complex orthopedic surgical issues including joint replacement of the hip, knee and shoulder, foot and ankle surgery, fracture surgery, spinal surgery and sports medicine.