[Hiring] Medical Billing and A/R Follow-Up Specialist @RCM Staff LLC

Role Description

This is a remote position.

We are hiring a full-time Medical Billing and A/R Follow-Up Specialist to support a psychiatry practice based in Illinois. You will handle professional claims from submission to payment across various settings, including:

• Inpatient psychiatric
• Skilled nursing
• Rehabilitation
• Intensive outpatient
• Outpatient

This role requires strong attention to detail, persistent follow-up, and experience working with U.S. health insurance plans, including Medicare and Medicaid.

Key Responsibilities

• Verify eligibility, benefits, and coordination of benefits, and confirm authorization requirements for intensive outpatient and inpatient services.
• Prepare and submit professional claims, confirming the correct place of service, provider, facility, and date of service.
• Work clearinghouse rejections and front-end edits daily, correcting and resubmitting claims the same day where possible.
• Follow up on unpaid claims by payer portal and phone, prioritizing aged claims and those at risk of missing a deadline.
• Work on denials using remittance advice and denial codes, then correct claims and file timely appeals and reconsiderations.
• Track timely filing and appeal deadlines by payer so that no claim is lost to a filing limit.
• Post and reconcile payments from ERAs and EOBs, and flag underpayments against fee schedules for review.
• Report recurring denial patterns by payer, provider, and reason code to the practice’s billing leadership.
• Document every action clearly in the billing system.
• Protect patient information and follow HIPAA requirements.

Qualifications

• At least 2 years of experience with U.S. healthcare insurance billing and A/R follow-up.
• Hands-on experience with claim submission, denial management, and appeals, including reading denial and remark codes.
• Familiarity with commercial insurance and government health plans, including Medicare, Medicaid, managed Medicaid, and Medicare Advantage.
• Experience using payer portals and insurance websites.
• Working knowledge of electronic claims and remittance (837/835, ERA/EOB).
• Basic Excel skills for tracking A/R and denials.
• Strong written and spoken English.
• Excellent attention to detail and follow-up skills.
• Ability to work independently and manage a large queue of claims across multiple payers.
• Reliable internet connection and a suitable remote workspace.

Preferred Qualifications

• Familiarity with Illinois Medicaid/Medicare and its managed care plans.
• Experience supporting psychiatry or behavioral health practices.
• Familiarity with psychiatric CPT codes, such as hospital care, nursing facility visits, psychiatric diagnostic evaluations, psychotherapy add-on codes, and outpatient E/M.
• Experience billing across multiple care settings, such as inpatient, skilled nursing, intensive outpatient, and outpatient.

Schedule

• Full-time position.
• Must be available during U.S. Central Time business hours.
• Final schedule will be determined based on practice needs.

Work Arrangement

Remote