RCM Specialist

 Posted a day ago
     
2-5 years experience
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AI Summary

The RCM Specialist manages prior authorizations, insurance verification, and benefits validation to ensure patient access to care. Additionally, the role supports revenue cycle functions including claim follow-up and denial resolution.

This is a remote position.

Company Overview:

Insight Therapy Solutions is a growing behavioral health organization dedicated to helping people access the care they need. Since 2012, we've combined compassionate service, strong clinical support, and operational excellence to create a positive experience for both clients and team members.

Why Join Us:

  • 100% remote – work from home

  • Join a growing behavioral health organization

  • Collaborative and supportive team environment

  • Opportunity to expand your Revenue Cycle Management expertise

  • Make a direct impact on patient access to care

Perks & Benefits:

  • Paid Time Off (PTO, 10 days annually)

  • Paid U.S. holidays

  • Paid birthday leave

  • Parental leave

  • Monthly health stipend

Position Overview:

The RCM Specialist supports revenue cycle operations with a primary focus on prior authorizations, insurance verification, benefits validation, and authorization renewals. This role also assists with other revenue cycle functions as needed, including claim follow-up and denial resolution.

We're looking for a detail-oriented professional who can effectively work with insurance companies, providers, and internal teams to help ensure patients receive timely access to services while supporting efficient reimbursement processes.

Key Responsibilities:

  • Submit, track, and manage prior authorization requests.

  • Verify patient eligibility, benefits, and authorization requirements.

  • Monitor authorization status and obtain approvals before scheduled services.

  • Initiate authorization renewals and resolve authorization-related issues.

  • Communicate with insurance companies regarding authorizations, benefits, and claim inquiries.

  • Coordinate with providers and internal teams regarding payer requirements and authorization updates.

  • Assist with claim follow-up, denial resolution, appeals, and other revenue cycle activities as needed.

  • Maintain accurate documentation and ensure compliance with payer guidelines, HIPAA regulations, and company policies.

What We're Looking For:

Required:

  • 2+ years of experience in Prior Authorizations, Insurance Verification, Medical Billing, Revenue Cycle Management, or a related healthcare role.

  • Experience working with U.S. healthcare insurance plans and payer portals.

  • Strong understanding of insurance eligibility, benefits verification, and authorization processes.

  • Excellent English communication skills.

  • Strong attention to detail, organization, and time management skills.

  • Ability to work independently in a remote environment.

Preferred:

  • Experience supporting behavioral health, mental health, or outpatient healthcare organizations.

  • Experience with accounts receivable follow-up, denial management, and claim resolution.

  • Experience using SimplePractice or similar EHR systems.

  • Familiarity with Availity, Waystar, or similar payer portals.

Key Competencies:

  • Attention to detail

  • Problem-solving

  • Organization and follow-through

  • Communication and collaboration

  • Accountability and adaptability

Work Environment:

Join a collaborative remote team where your work directly impacts patient access to care. You'll work closely with providers, billing professionals, and healthcare operations staff to support efficient revenue cycle processes.



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