Medical Biller, RCM Specialist
Posted 3 hours ago
You'll complete your application on Staffing For Doctors's career site.
About the Role
A clinical practice is looking for a meticulous Medical Biller and Revenue Cycle Management Specialist to optimize financial workflows. You will be tasked with monitoring and auditing the work of outsourced billing partners to guarantee precision and boost revenue collection. As a key administrator, you will find billing deficiencies, handle intricate claims, and ready the practice for a move to internal billing operations. This position allows you to influence the financial performance of the clinic through careful management and independent oversight. While the work is currently part-time, you must be prepared to adjust to a potential future transition to a full-time schedule. You should excel in a detail-focused setting, delivering periodic financial reports to management and ensuring all financial tasks align with state and federal regulations.
Requirements
- You must have a minimum of three years of professional experience in medical coding and billing, specifically regarding claims auditing, denial management, and accounts receivable follow-up.
- You need direct background in mental or behavioral health billing, including a solid understanding of psychiatric CPT codes, regional payor regulations, and pre-authorization needs.
- You should have knowledge of California-specific billing laws, regional payor policies, and local credentialing procedures.
- You must have experience tracking billing performance metrics and supervising third-party billing vendors.
- You are required to work from a secure, HIPAA-compliant home office equipped with a fast computer, stable high-speed internet, and a headset.
- Experience with the OnlyMD billing and EMR platform is preferred, as is prior involvement in shifting billing functions from an external vendor to an in-house team.
- You must be available for about 20 hours weekly between 10:00 AM and 7:00 PM PST, with the capacity to increase your hours to full-time if needed.
Responsibilities
- You will evaluate daily submissions from external billing partners by comparing encounter data with filed claims to uncover coding mistakes, incomplete information, or ignored tasks.
- You will oversee a queue of billing items, including a backlog of approximately 90 days and several hundred unprocessed encounters.
- You will identify reasons for unpaid or denied claims, conduct appeals and resubmissions, and keep detailed logs of billing activities.
- You will serve as the lead contact for insurance providers and billing vendors to correct inconsistencies.
- You will review behavioral health encounters to ensure the accuracy of ICD-10 and CPT codes.
- You will generate weekly reports on accounts-receivable recovery for leadership and highlight recurring issues with vendors.
- You will record existing workflows and lead the strategy for migrating revenue cycle management tasks in-house.
Note: This listing is summarized and paraphrased by WorkNow from a publicly posted role. For the original wording and full details, please refer to the employer's official posting.
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