RCM Specialist / Certified Professional Coder (CPC)

Hours: M-F, 8:00 AM - 4:30 PM local time

Job Summary: 

Workit Health is seeking a full-time RCM Specialist to work rejections and denials as they come in and escalate any denial or rejection trends as they are identified. Candidate ideally has experience billing for addiction medicine and/or outpatient medication-assisted treatment or experience in billing for telemedicine services. Experience in both is a plus but is not required. Experience with calling health insurance plans a must. Excellent customer service skills. Candidates will demonstrate patient and empathetic communication to our members, be able to work accounts promptly and be open to workflow changes. Workit Health is a fast-paced, fluid environment where changes are frequent and employee input is highly valued.

Core Responsibilities:

• Proficient in medical software, insurance websites, and EHR systems (Elation or Candid preferred)
• Verify patient eligibility and benefits including coordination of benefits
• Identify and resolve claims processing issues, including pre-submission errors, and generate appeals or reprocess claims as needed
• Communicate effectively with patients, physicians, management, staff, and third-party representatives
• Contact insurance payers for eligibility, claims resolution, and authorization requests
• Submit medical records to insurance when needed
• Review and audit patient accounts for accuracy
• Maintain compliance with professional standards, company policies, and federal, state, and HIPAA regulations
• Manage a high volume of claims, calls, chats, and tasks while meeting productivity and quality standards
• Respond promptly to all calls, chats, and voicemails during business hours
• Maintains positive and optimistic attitude
• Ensure timely completion of daily tasks
• All other duties as assigned

Qualifications:

• 1-2 years previous Medical Billing experience
• Certified Professional Coder or Biller (CPC / CPB) required
• Payment Posting is a plus but not required
• Must be able to work independently and rely on personal knowledge/experience for problem-solving.
• Must have experience with MS Word and Google Sheets or MS Excel
• Must be detail-oriented and have excellent organizational and time management skills
• Candidates must excel at providing a high level of customer service and be able to work in a team environment
• Requires strong analytical skills and attention to detail, including writing and verbal communication skills and a professional positive attitude

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