RCM Coordinator

SCIOMETRIX INC
  • Somerset, NJ
  • Full-time
7 days ago

Job Description

Benefits:
  • Dental insurance
  • Health insurance
  • Paid time off
  • Vision insurance


About the Role
 


We are seeking a highly organized and detail-oriented RCM Coordinator to join our Revenue Cycle Management team. This role serves as an operational hub between coding, billing, clinical staff, and payers — coordinating daily RCM workflows, monitoring claim status, resolving front-line issues, and keeping communication flowing so the revenue cycle runs smoothly from patient encounter to payment posting. This is a full-time, on-site role located in our Somerset, NJ office. 
 
Key Responsibilities 



Daily Coordination & Communication
 


  • Monitor and manage the shared RCM/billing mailbox daily — triage payer correspondence, denial notices, patient billing inquiries, and internal requests, routing each to the right team member and responding within SLA. 
  • Serve as the first point of contact for coding, billing, and collections questions from internal clinical and administrative staff. 
  • Coordinate communication between coders, billers, physicians, nurse practitioners, and payers to resolve documentation gaps or claim holds. 
  • Maintain and update trackers/logs (claims in process, denials, pending documentation, escalations) and share status updates with the RCM Manager. 
  • Make outbound calls to patients to verify insurance coverage and update account information as needed. 

Claims & Billing Workflow Support
 


  • Track claims through the full billing cycle — submission, clearinghouse acceptance, payer adjudication, denial/appeal, and payment posting. 
  • Review claim edits, rejections, and clearinghouse reports; route corrections to the appropriate coder or biller and follow up to closure. 
  • Support timely charge entry and claims submission by confirming encounters, documentation, and coding are complete and ready for billing. 
  • Assist with insurance verification, eligibility checks, and prior authorization tracking as needed. 
  • Help prepare and distribute daily/weekly RCM reports (claims submitted, denials, AR aging, first-pass acceptance rate). 

Denial & AR Follow-Up
 


  • Log and categorize denials, identify trends, and escalate recurring issues to coding, billing, or payer contacts. 
  • Support timely appeals by gathering documentation, correcting claims, and coordinating resubmission with the billing team. 
  • Follow up on aged accounts receivable and outstanding payer balances, documenting all activity in the practice management/EHR system. 

Compliance & Process Improvement
 


  • Ensure all coordination activities comply with HIPAA, CMS, and payer-specific telehealth billing guidelines. 
  • Identify workflow bottlenecks and recommend process improvements to reduce denials and improve first-pass acceptance rate (FPAR). 
  • Maintain accurate, organized documentation and audit trails to support pre-billing and compliance reviews. 
  • Stay current on payer policy changes, telehealth regulations, and RCM industry best practices. 

Required Qualifications
 


  • High school diploma or equivalent required; Associate's degree in healthcare administration, business, or related field preferred. 
  • 4–6 years of experience in medical billing, revenue cycle, or healthcare administrative coordination (telehealth or outpatient setting a plus). 
  • Working knowledge of ICD-10, CPT, and HCPCS coding concepts, and payer billing requirements (Medicare, Medicaid, Commercial, CCM, RPM). 
  • Proficiency with EMR/EHR and practice management/billing software, plus strong Microsoft Office/Outlook skills. 
  • Excellent written and verbal communication skills; comfortable managing high email and phone volume and cross-team follow-up. 
  • Strong organizational skills and attention to detail in a deadline-driven RCM environment. 
  • Ability to multitask, prioritize, and track multiple open items to resolution. 

Preferred Skills
 


  • Coding or billing certification (CPC, CBCS, CMAA, or similar) a plus, though not required for this coordinator-level role. 
  • Experience with denial management, AR follow-up, or pre-billing audit workflows. 
  • Familiarity with telehealth-specific billing models (CCM, RPM, virtual visits). 
  • Strong analytical and problem-solving skills; comfortable working independently and collaboratively. 

Numbers & Facts

LocationSomerset, NJ
Job TypeFull-time

Skills

  • Accounts Receivableunmatched
  • Adjudicationunmatched
  • Administrative Skillsunmatched
  • Analysis Skillsunmatched
  • Billingunmatched
  • Billing Softwareunmatched
  • Certified Professional Coder (CPC)unmatched
  • Claims Processingunmatched
  • Communication Skillsunmatched
  • Content Management Systems (CMS)unmatched
  • Credit and Collectionsunmatched
  • Current Procedural Terminology (CPT)unmatched
  • Dental Insuranceunmatched
  • Detail Orientedunmatched
  • Documentationunmatched
  • Electronic Medical Recordsunmatched
  • Email Management/Administrationunmatched
  • Establish Prioritiesunmatched
  • HIPAA (Health Insurance Portability and Accountability Act)unmatched
  • Health Insuranceunmatched
  • Healthcare Administrationunmatched
  • Healthcare Common Procedure Coding System (HCPCS)unmatched
  • High School Diplomaunmatched
  • ICD-10unmatched
  • Medicaidunmatched
  • Medical Billingunmatched
  • Medical Codingunmatched
  • Medical Record Systemunmatched
  • Medicareunmatched
  • Microsoft Officeunmatched
  • Microsoft Outlookunmatched
  • Multitaskingunmatched
  • Nursingunmatched
  • Organizational Skillsunmatched
  • Outpatient Careunmatched
  • Patient Care Denialsunmatched
  • Payment Postingunmatched
  • Practice Management Softwareunmatched
  • Presentation/Verbal Skillsunmatched
  • Problem Solving Skillsunmatched
  • Process Improvementunmatched
  • RPMunmatched
  • Revenue Managementunmatched
  • Service Level Agreement (SLA)unmatched
  • Telehealthunmatched
  • Time Managementunmatched
  • Trend Analysisunmatched
  • Vision Planunmatched
  • Workflow Analysisunmatched
  • Writing Skillsunmatched

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