P4P
We are seeking a skilled Revenue Cycle Manager(RCM) with experience in
post-submission workflows, denial resolution, and accounts receivable (AR) recovery for a high-complexity clinical laboratory serving clients in women’s health, toxicology, and genetics.
This role ensures that claims are not only submitted correctly, but also monitored, appealed, and recovered efficiently — driving revenue integrity and cash flow performance.
Responsibilities:
Review and track submitted claims to ensure timely processing and identify any delays, denials, or underpayments.
Analyze denial codes, EOBs, and remittance data to determine root causes and corrective actions.
Initiate and manage appeals, reconsiderations, or corrected claims to maximize reimbursement.
Collaborate with coding and pre-submission teams to close the feedback loop and prevent recurring errors.
Maintain accurate documentation and follow-up logs within the billing system or RCM platform.
Communicate with payers, clearinghouses, and internal departments to resolve billing discrepancies and verify payment statuses.
Prepare regular AR aging and recovery performance reports for stakeholders and leadership.
Identify trends in payer behavior and propose process improvements to increase clean claim rate and reduce DSO (Days Sales Outstanding).
Qualifications:
2+ years of experience in medical billing, RCM, or AR follow-up (laboratory or diagnostic experience strongly preferred).
Deep understanding of EOB interpretation, denial management, and payer appeals.
Working knowledge of claim adjudication, ERA/EOB reconciliation, and payer portals.
Familiarity with CPT, ICD-10, and HCPCS coding, as well as payer-specific reimbursement rules.
Experience using billing software, clearinghouses, and RCM dashboards for tracking and reporting.
Certification (e.g., CPC, COC, CRCR) preferred but not required.
Personal Skills:
Strong analytical and critical-thinking abilities to assess complex claim issues.
Excellent written and verbal communication, especially for payer correspondence.
High degree of accuracy and accountability.
Ability to work collaboratively with cross-functional teams including clinical, operations, and finance.
Persistent and resourceful with a problem-solver mindset.
Self-motivated and organized with a focus on measurable results.
Work Location: In person
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post-submission workflows, denial resolution, and accounts receivable (AR) recovery for a high-complexity clinical laboratory serving clients in women’s health, toxicology, and genetics.
This role ensures that claims are not only submitted correctly, but also monitored, appealed, and recovered efficiently — driving revenue integrity and cash flow performance.
Responsibilities:
Review and track submitted claims to ensure timely processing and identify any delays, denials, or underpayments.
Analyze denial codes, EOBs, and remittance data to determine root causes and corrective actions.
Initiate and manage appeals, reconsiderations, or corrected claims to maximize reimbursement.
Collaborate with coding and pre-submission teams to close the feedback loop and prevent recurring errors.
Maintain accurate documentation and follow-up logs within the billing system or RCM platform.
Communicate with payers, clearinghouses, and internal departments to resolve billing discrepancies and verify payment statuses.
Prepare regular AR aging and recovery performance reports for stakeholders and leadership.
Identify trends in payer behavior and propose process improvements to increase clean claim rate and reduce DSO (Days Sales Outstanding).
Qualifications:
2+ years of experience in medical billing, RCM, or AR follow-up (laboratory or diagnostic experience strongly preferred).
Deep understanding of EOB interpretation, denial management, and payer appeals.
Working knowledge of claim adjudication, ERA/EOB reconciliation, and payer portals.
Familiarity with CPT, ICD-10, and HCPCS coding, as well as payer-specific reimbursement rules.
Experience using billing software, clearinghouses, and RCM dashboards for tracking and reporting.
Certification (e.g., CPC, COC, CRCR) preferred but not required.
Personal Skills:
Strong analytical and critical-thinking abilities to assess complex claim issues.
Excellent written and verbal communication, especially for payer correspondence.
High degree of accuracy and accountability.
Ability to work collaboratively with cross-functional teams including clinical, operations, and finance.
Persistent and resourceful with a problem-solver mindset.
Self-motivated and organized with a focus on measurable results.
Work Location: In person
#J-18808-Ljbffr