RCM Coordinator

About the Role We are seeking a highly organized and detail-oriented RCM Coordinator to join our Revenue Cycle Management team. This role serves as an operational hub between coding, billing, clinical staff, and payers — coordinating daily RCM workflows, monitoring claim status, resolving front-line issues, and keeping communication flowing so the revenue cycle runs smoothly from patient encounter to payment posting. This is a full-time, on-site role located in our Somerset, NJ office. Key Responsibilities

Daily Coordination & Communication 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.

Claims & Billing Workflow Support 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).

Denial & AR Follow-Up 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.

Compliance & Process Improvement 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.

Required Qualifications 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.

Preferred Skills 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.