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Healthcare Revenue Cycle Professionals Wanted
2 weeks ago
We are seeking experienced professionals to fill various roles within our Healthcare Revenue Cycle Management team. Individuals with expertise in Medical Coding, Billing, Denial Management, Prior Authorization, Credentialing, Front Office Coordination, or RCM Team Leadership are encouraged to apply.
Roles and ResponsibilitiesMedical Coder- Review clinical documentation and assign ICD-10, CPT, and HCPCS codes.
- Ensure coding accuracy per CMS and payer guidelines.
- Collaborate with providers for documentation clarification.
- Utilize EHRs such as eClinicalWorks, Epic, Cerner, and Athena.
- Submit insurance claims (manual/electronic) and follow up on rejections.
- Post payments and reconcile accounts.
- Verify patient insurance coverage and benefits.
- Handle Medicare, Medicaid, and commercial insurances.
- Analyze EOBs and identify root causes of denials.
- Draft and submit appeals with supporting documentation.
- Maintain denial logs and collaborate with coding and billing teams.
- Submit prior auth requests to insurance companies.
- Track approvals and communicate statuses to providers/patients.
- Ensure compliance with payer turnaround timelines.
- Submit and track credentialing applications with payers.
- Maintain provider profiles (CAQH, PECOS).
- Coordinate with providers for documentation and compliance.
- Answer inbound calls from patients and insurance reps.
- Handle billing queries, coverage explanations, denial statuses, and prior auth info.
- Document interactions in EMR/CRM systems.
- Ensure HIPAA compliance and quality service.
- Lead a team across medical coding, billing, denial management, and credentialing.
- Ensure SLA/KPI adherence, client communication, and team development.
- Monitor quality, manage escalations, and enforce compliance protocols.