RCM Billing Specialist
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Job Description
RCM Billing Specialist at StrataPT managing billing denials and claims for healthcare providers. Collaborating with internal teams to ensure accurate reimbursements and process improvements.
Responsibilities:
- Leading high-level claim follow-up and appeals
- Researching and resolving nuanced billing denials
- Collaborating with internal billing and RCM teams
- Working within payer portals to manage denials and submit appeals
- Identifying denial trends and recommending process improvements
- Manage complex aged AR and escalated denials
- Prepare and submit thorough appeals with supporting documentation
- Independently navigate payer rules across Medicare, Medicaid, and commercial plans
- Educate patients on billing issues and payment options
- Track patterns in payer denials and suggest systemic improvements
- Validate denial coding accuracy and appeal when necessary
- Escalate exhausted appeal efforts using internal escalation pathways
Requirements:
- A college degree is preferred, but not required
- 2ā3+ years in healthcare AR or denial management
- Deep knowledge of CPT/ICD-10, UB04, and CMS 1500 forms
- Direct experience with reimbursement patterns, coding nuances, or appeals strategy in physical therapy, occupational therapy, speech therapy, or ABA
- Excellent communication, organization, and multitasking abilities
- Strong problem-solving skills and ability to work independently
- Tech-savvy with advanced experience in payer websites and portals
- Ability to manage confidential information with discretion
Benefits:
- Medical, Dental, Vision, Life & AD&D
- Short- and Long-Term Disability (coverage begins on Day 1)
- Simple IRA with 3% company match (eligible after 1 year)
- Paid Time Off: 14 days PTO annually
- 7 company holidays + 1 floating holiday
- Flexible schedule, with a shared rhythm during standard business hours (MondayāFriday, 9:00 AM to 5:00 PM ET)
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