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RCM Accounts Receivable Specialist

Netsmart Technologies

Responsible for resolving outstanding insurance accounts receivable through proactive follow-up, denial management, appeals, and payer communication. The role focuses on maximizing reimbursement, identifying denial trends, and improving revenue cycle performance for assigned client accounts.

The position requires daily use of Microsoft Excel and Outlook to manage account inventories, communicate with payers, track claim activity, and analyze denial trends.

Key duties include managing aged claims, working denial inventory, investigating claim edits and rejections, handling EDI-related reconciliation, and documenting resolution efforts. The role also involves using automation, RPA, and AI-assisted workflows to improve efficiency and claim resolution outcomes.

Requirements & Qualifications

Required

  • High school diploma or GED
  • 1+ year of healthcare accounts receivable, medical billing, or denial management experience
  • Experience researching and resolving insurance claim denials and payer reimbursement issues
  • Advanced Microsoft Excel skills, including VLOOKUP/XLOOKUP, Pivot Tables, filters, formulas, and spreadsheet management
  • Strong Microsoft Outlook proficiency for high-volume correspondence
  • Understanding of insurance reimbursement processes, claim adjudication, Medicare, Medicaid, and commercial payer requirements
  • Strong analytical, critical thinking, and problem-solving skills
  • Excellent verbal and written communication skills
  • Ability to manage productivity metrics and work independently in a fast-paced environment

Preferred

  • Experience in behavioral health, post-acute care, home health, long-term care, or specialty healthcare billing
  • 2+ years of insurance AR follow-up and denial management experience
  • Collections experience in a healthcare revenue cycle environment
  • Experience preparing and submitting formal appeals to insurance carriers
  • Working knowledge of medical billing systems such as Medic, IDX, Avatar, Tier, Medical Manager, or similar platforms
  • Experience with automation tools, AI-enabled workflows, or revenue cycle technology solutions

Location

N/A

Employment Type

Full-time

Experience Level

Entry Level

Remote work allowed

Yes

Posted

2 weeks ago

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