RCM Specialist II

The RCM Specialist II is an individual contributor role on the Revenue Cycle Management (RCM) team, responsible for accounts receivable (AR) follow-up, posting payments, processing refunds and credits, and auditing accounts accurately. This role supports the full revenue cycle to ensure timely resolution of outstanding balances, clean financial records, and smooth experiences for both practices and patients.

Key responsibilities include performing AR follow-up to resolve unpaid or underpaid claims, denials, and aged balances through appeals, corrections, and resubmissions; auditing accounts for accurate claim submission and payment application; reviewing and resolving credit balances; posting payments accurately and timely; applying adjustments and write-offs per payer contracts; managing AR aging reports to reduce days in AR and percentages over 90 days; maintaining documentation; collaborating with billing and front office teams; and ensuring compliance with HIPAA and payer guidelines.

The specialist also participates in team meetings to discuss metrics and process improvements, supporting management with key performance indicator (KPI) analysis, including collection rates, days in AR, and aged receivables. They identify trends in rejections, disputes, payment delays, and denials to improve processes.