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Job Summary

RCM Staff BPO is hiring a full-time Medical Billing Specialist to support a behavioral health and substance use disorder treatment program based in US.

The specialist will handle the full billing cycle, from reviewing claims in the EHR through claim submission, payment posting, and A/R follow-up. This role requires end-to-end billing ownership and experience with Medicaid, such as strong attention to detail, consistent follow-up, and experience working with U.S. health insurance plans.

Key Responsibilities

* Review and work the claims queue in the EHR and prepare clean claims for submission

* Enter charges and submit claims through the billing system and clearinghouse

* Monitor clearinghouse rejections and correct and resubmit claims promptly

* Post insurance payments and adjustments from ERAs and EOBs

* Follow up on unpaid and underpaid claims through payer portals and phone calls

* Work denials, identify root causes, and submit corrections and appeals

* Track Medicaid and managed care authorization and billing requirements

* Support the transition of billing from a prior billing company, including reviewing open A/R

* Report billing status, A/R trends, and issues to the practice

* Protect patient information and follow HIPAA requirements

Qualifications

* At least 2 years of experience with U.S. healthcare insurance

* Hands-on experience with end-to-end medical billing, including claim submission, payment posting, A/R, and denials

* 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 billing for behavioral health or substance use disorder treatment programs

* Experience using EZClaim, ClaimMD, or BestNotes

* Familiarity with Utah Medicaid and Select Health

* Experience with Medicaid managed care billing, authorizations, and level-of-care billing

Schedule

* Full-time position

* Must be available during Mountain Time business hours

* Final schedule will be determined based on practice needs

Work Arrangement

* Remote

* Philippines-based applicants preferred

RCM Staff LLC

Employees 11-50 employees Industry Hospitals and Health Care

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