What are the responsibilities and job description for the RCM Billing Specialist position at REVASCENT LLC?
Position Summary
The RCM Biller is responsible for preparing, reviewing, and submitting clean claims to insurance payers in accordance with payer requirements. The role ensures accuracy in coding, documentation, modifier usage, and claim edits to support timely reimbursement.
Key Responsibilities
Claim Preparation & Submission
- Review charge accuracy, coding alignment, modifiers, NPI mapping, and documentation.
- Submit electronic and paper claims according to payer guidelines and daily deadlines.
- Correct claim scrubber edits and clearinghouse rejections.
Error Resolution
- Research payer policies to resolve billing issues.
- Communicate documentation or coding discrepancies to charge entry or coding staff.
- Maintain a claim submission log and track delayed or high-risk claims.
Payer Compliance
- Monitor payer rule updates and adjust billing workflows accordingly.
- Reduce first-pass rejections by identifying and correcting recurring issues.
Cross-Functional Coordination
- Collaborate with authorization, charge entry, denials, and AR follow-up teams.
- Provide feedback to improve upstream claim accuracy.
Qualifications
Required
- 1–3 years of medical billing experience.
- Knowledge of CPT/HCPCS, ICD-10, and modifier requirements.
- Experience with electronic claim submission and clearinghouse workflows.
Preferred
- Experience with high-volume specialty billing (retina, ophthalmology, or multi-specialty).
- Familiarity with PM/EHR systems (e.g., Healthpac, NextTech, ModMed, ECW, Athena, MedInformatics, AdvancedMD).
Core Competencies
Detail-oriented
- Understanding of payer rules
- Communication skills
- Problem-solving
- Organization
- ·Technical proficiency
Work Environment
- Remote or hybrid depending on organizational needs.
- May require periodic internal meetings or training sessions.
Salary: $18.00-26.00 per hour DOE
Salary : $18 - $26