RCM Billing Specialist- Medical Billing Experience

Responsibilities

• Prepare and submit clean claims to various insurance companies either electronically or by paper

• Research, resolve, and report on unbilled claims identified in the client billing solution; troubleshoot and resolve/escalate billing errors occurring in the care record

• Handle Electronic Data Interchange EDI transactions, including reconciling carrier submissions, edits and rejection reports

• Provide customer service support for patients, client administrative staff and insurance companies

• Prepare, review, and send patient statements to mailing service

• Meet defined productivity standards

• Utilize RPA tools and AI-assisted workflows to automate routine claim follow-up tasks and enhance processing efficiency

Qualifications
Required

• High school diploma or GED

• At least 1 year of customer service work experience

• Proficient in Microsoft Office Suite including Excel, Outlook, and Word

• Demonstrated ability to maintain strict confidentiality

• Experience with or willingness to learn automation tools and AI-powered revenue cycle management systems

Preferred

• At least 1 year of medical billing, cash posting, or charge entry work experience

• Medical coding certification such as a Certified Professional Coder (CPC)

• Experience handling customer escalations and resolving complex issues in a call center environment

• Understanding of and adherence to all Health Insurance Portability and Accountability Act (HIPAA) guidelines and regulations

Expectations

• Comfortable with remote work arrangements and virtual collaboration tools

• Physical demands include extended periods of sitting, computer use, and telephone communication

Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all individuals. We celebrate diversity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.

Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmart's sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the individual can provide proof of valid prescription to Netsmart's third party screening provider.

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