[Hiring] Medical Billing Specialist @RCM Staff LLC

Role Description

This is a remote position.

RCM Staff BPO is hiring a part-time Accounts Receivable (A/R) and Denial Management Specialist to support a chiropractic practice based in Idaho. The specialist will work the practice's unpaid and denied claims, following up with payers, finding the root cause of each denial, and preparing corrected claims and appeals until they're resolved. The role requires chiropractic billing experience, strong attention to detail, consistent follow-up, and experience with U.S. health insurance plans.

Key Responsibilities

• Review aging reports and follow up on any claim unpaid 30 days or more after submission
• Contact payers by phone, portal, and website to check claim status and get resolution
• Analyze denials and remittance codes (CARC/RARC) to find the root cause
• Prepare and submit corrected claims, reconsiderations, and written appeals, with supporting documentation
• Track every appeal through to a final decision, and escalate when a payer doesn't respond
• Work denied exam and evaluation claims, including modifier and medical necessity issues
• Note recurring denial trends and report them to the practice so the cause gets fixed at the front end
• Document all follow-up activity clearly in the practice management system
• Protect patient information and follow HIPAA requirements

Qualifications

• At least 2 years of experience with U.S. healthcare insurance A/R follow-up and denial management
• Chiropractic billing experience required
• Experience writing and submitting appeals and reconsiderations
• Familiarity with commercial insurance and government health plans
• Experience using payer portals and insurance websites
• Strong written and spoken English
• Excellent attention to detail and follow-up skills
• Ability to work independently and manage multiple patient accounts
• Reliable internet connection and a suitable remote workspace

Preferred Qualifications

• Experience using ChiroTouch
• Familiarity with Idaho insurance plans, such as Blue Cross of Idaho and Regence BlueShield of Idaho
• Knowledge of chiropractic coding rules, such as CMT codes 98940 to 98942, modifier 25 on same-day exams, the AT modifier for Medicare, and therapy codes for ultrasound, electrical stimulation, and massage
• Experience working with non-covered services such as decompression and cold laser

Schedule

• Part-time position (20 hours per week), with the opportunity to move to full-time based on performance and practice needs
• Must be available during Mountain Time business hours
• Final schedule will be determined based on practice needs

Work Arrangement

• Remote
• Philippines-based applicants preferred