Revenue Cycle Management (RCM) Specialist

Are you a detail-oriented professional with a passion for healthcare billing and revenue cycle optimization? Join our team as a RCM Specialist , where you’ll play a critical role in managing the full spectrum of revenue cycle activities—from benefit verification and authorization to claim submission and collections. This is a dynamic, independent role ideal for someone who thrives in a fast-paced environment and is committed to accuracy and efficiency. Please Note: This position is on-site at our office in Middletown, PA. Key Responsibilities: Verify patient benefits and manage authorizations for mental health services. Submit claims within established timeframes and monitor their progress. Navigate payer portals and EMR dashboards to complete tasks and follow-ups. Investigate and resolve unbilled charges and unpaid claims. Track and analyze billing and collection trends to identify improvement opportunities. Lead collection efforts for assigned payers, including secondary insurance claims. Escalate unresolved claims appropriately, both internally and externally. Collaborate across departments to streamline the AR recovery process. Maintain clear and professional communication with internal teams and external stakeholders. Ensure accurate documentation of all payer interactions. Uphold HIPAA compliance and patient privacy standards. Perform other duties as assigned. Qualifications: High School diploma or equivalent; 3–5 years of relevant experience. Strong understanding of third-party payer requirements (federal, state, commercial). Proven track record in healthcare billing, including Medicaid and Managed Care. Familiarity with EMR systems (preferred). Solid grasp of insurance policies, procedures, and reimbursement practices. Highly organized with strong attention to detail. Experience in process development and execution. Excellent communication and interpersonal skills. Proficient in Microsoft Office, especially Excel. #J-18808-Ljbffr ZMark Health