Revenue Cycle Specialist

Position Summary

We are seeking an experienced Revenue Cycle Specialist to handle the full RCM process from claim submission through payment resolution. The ideal candidate will possess strong knowledge of insurance billing, reimbursement methodologies, denial management, and revenue cycle operations.

This role is critical to ensuring accurate claim submission, maximizing reimbursement, reducing denials, and maintaining compliance with payer requirements and regulatory guidelines.

Location: ONSITE in Decatur, GA

Pay rate: $20-26/hour based on experience

Schedule: Monday-Friday 8am-5pm. No weekends or evenings!

Key Responsibilities

• Submit accurate and timely insurance claims to commercial, government, and managed care payers.
• Review and resolve claim edits, rejections, denials, and payer correspondence.
• Conduct follow-up on unpaid, denied, or underpaid claims to ensure timely reimbursement.
• Prepare and submit claim appeals with supporting documentation when appropriate.
• Review coding and billing information for accuracy and identify discrepancies that may affect reimbursement.
• Post and reconcile insurance and patient payments.
• Monitor accounts receivable balances and analyze aging reports to identify collection opportunities.
• Communicate with insurance companies regarding claim status, reimbursement issues, and authorization requirements.
• Respond to patient billing inquiries and assist with payment-related questions.
• Maintain accurate billing documentation within the electronic medical record (EMR) system.
• Collaborate with providers and clinical staff to resolve documentation and coding issues that impact revenue cycle performance.
• Perform additional duties as assigned.

Required Qualifications:

• High school diploma or equivalent; Associate degree preferred.
• Minimum of three (3) years of RCM experience within pain management.
• Experience following up with Medicare, Medicaid, and commercial insurance carriers about payment status.
• Experience handling denied claims and the appeals process.
• Experience posting payments.
• Excellent organizational, analytical, and problem-solving skills.

Preferred Qualifications:

• Experience with eClinicalWorks (ECW)
• Experience with workers' compensation and/or personal injury claims

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, Los Angeles County Fair Chance Ordinance, and San Francisco Fair Chance Ordinance.