Join a fast-moving revenue cycle team supporting clinicians by converting services rendered into accurate claims and ensuring timely reimbursement. You’ll learn the full claim lifecycle—from charge entry through payment posting and denials—while working with experienced mentors.
Translate clinical services into standardized codes (ICD-10-CM, CPT, HCPCS) with high accuracy.
Prepare, submit, and track claims to commercial, Medicare, and Medicaid payers.
Verify benefits, obtain basic authorizations, and resolve eligibility issues.
Post payments/adjustments from EOBs/ERAs; research underpayments and short pays.
Work aging reports; investigate and resolve denials using payer portals.
Maintain strict confidentiality and data integrity across all systems and documents.
Collaborate with clinicians, front office, and finance to prevent rework and improve first-pass yield.
MediClear (or equivalent HIPAA compliance certification) — required.
Working knowledge of medical billing software and MS Office (Excel/Outlook).
Familiarity with medical terminology and the basics of ICD-10/CPT/HCPCS coding.
Strong numeracy, attention to detail, and clear written/verbal communication.
High integrity and professionalism handling PHI in accordance with HIPAA.
Exposure to clearinghouses and payer portals (Availity, Optum, etc.).
Experience reading EOBs/ERAs and basic denial reason codes.
AAPC or AHIMA entry-level credential (e.g., CPB , CPC-A , CCS-P ) or completion of a billing/coding program.
Training and mentorship with clear advancement paths in RCM.
Collaborative culture, modern tools, and meaningful work that impacts patient care.
Competitive pay with benefits (details provided during interview).
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