RCM and Billing Support

Job Title: RCM and Billing Support

Job Type: Full-time

Location: Remote

Job Summary:

Join our team as an RCM and Billing Support specialist, where you will leverage your analytical skills and in-depth experience with revenue cycle management to solve complex billing challenges. You will play a pivotal role in ensuring clean claims and timely reimbursement by identifying, troubleshooting, and resolving systemic RCM issues across multiple medical billing systems. This position is ideal for hands-on experts passionate about optimizing healthcare billing processes and delivering tangible results.

Key Responsibilities:

• Investigate and resolve advanced claim rejections, posting mismatches, configuration errors, and payer mapping issues across a range of billing systems (e.g., CollaborateMD, Kareo, AdvancedMD, eClinicalWorks, DrChrono, Athenahealth, NextGen, PracticeSuite).

• Analyze complex denial trends, perform root cause analysis, and implement solutions to prevent recurring issues.

• Support charge entry, payment posting, AR follow-up, and payer-specific workflows while ensuring accuracy and compliance.

• Liaise with payers and internal teams to clarify and resolve Medicare, Medicaid, and commercial payer issues.

• Interpret and apply knowledge of CPT, ICD-10, HCPCS, modifiers, and ERA/EDI 835/837 data formats.

• Maintain compliance with HIPAA and 42 CFR Part 2 for all data handling and documentation.

• Collaborate cross-functionally to optimize configurations and streamline RCM processes for improved outcomes.

Required Skills and Qualifications:

• Deep, hands-on expertise in U.S. Healthcare Revenue Cycle Management, including denial analysis, charge entry, payment posting, and payer workflows.

• Demonstrated troubleshooting experience with claim errors, posting discrepancies, configuration, and payer mapping.

• Proficiency with multiple medical billing systems such as CollaborateMD, Kareo, AdvancedMD, eClinicalWorks, DrChrono, Athenahealth, NextGen, PracticeSuite, or similar.

• Working knowledge of payer rules for Medicare, Medicaid, and commercial plans.

• Strong understanding of CPT, ICD-10, HCPCS codes, modifiers, and electronic remittance advice/data interchange formats.

• Exceptional written and verbal communication skills, with a customer-focused, solutions-driven mindset.

• Awareness of HIPAA and 42 CFR Part 2 regulations for sensitive health information.

Preferred Qualifications:

• Experience leading process improvement or system optimization initiatives within RCM.

• Familiarity with automated billing workflows and healthcare data integration.

• Certification in medical billing, coding, or RCM.