RCM Specialist / Certified Professional Coder (CPC)

The RCM Specialist / Certified Professional Coder will support revenue cycle management activities by ensuring accurate claims processing, resolving billing issues, and maintaining compliance with healthcare regulations. This role works closely with patients, providers, insurance organizations, and internal stakeholders to improve reimbursement workflows and operational performance.

• Manage incoming claim rejections and denials, identify root causes, and escalate recurring trends for resolution.
• Verify patient eligibility, benefits, and coordination of benefits to support accurate billing processes.
• Review and resolve claims processing issues, including pre-submission errors, appeals, and claim reprocessing requests.
• Contact insurance payers regarding eligibility, claims resolution, and authorization requirements.
• Submit medical records and supporting documentation to insurance providers when required.
• Review and audit patient accounts to ensure accuracy and completeness.
• Maintain compliance with professional standards, internal policies, and applicable healthcare regulations, including HIPAA requirements.
• Manage a high volume of claims, calls, chats, and administrative tasks while meeting quality and productivity expectations.
• Communicate effectively with patients, healthcare providers, management, staff, and third-party representatives.
• Support continuous workflow improvements and adapt to evolving processes in a dynamic environment.

Requirements:

The ideal candidate has experience in medical billing, coding, and revenue cycle operations, with strong organizational skills and the ability to independently manage complex billing tasks. A customer-focused mindset and attention to accuracy are essential for success in this role.

• 1–2 years of previous medical billing experience.
• Active Certified Professional Coder (CPC) or Certified Professional Biller (CPB) certification required.
• Experience with addiction medicine, outpatient medication-assisted treatment, or telemedicine billing is preferred.
• Experience contacting insurance companies and working with payer requirements is required.
• Knowledge of medical software, insurance portals, and electronic health record (EHR) systems; experience with Elation or Candid is a plus.
• Strong analytical skills with excellent attention to detail and problem-solving abilities.
• Ability to work independently, prioritize tasks, and manage deadlines effectively.
• Excellent written and verbal communication skills with a professional and empathetic approach.
• Strong customer service skills and the ability to collaborate effectively within a team environment.
• Proficiency with Microsoft Word, Google Sheets, or Microsoft Excel.

Benefits:

• Fully remote work opportunity within the United States.
• Competitive hourly pay range of approximately $24.50–$25.50 USD.
• 5 weeks of paid time off, including birthday time, mental health days, and floating holidays.
• 11 paid company holidays.
• Comprehensive medical, dental, pharmacy, and vision insurance options.
• 12 weeks of paid parental leave after one year of employment.
• 401(k) plan with 4% employer matching.
• Flexible Spending Accounts (FSA and dependent care FSA) and Health Savings Account (HSA) options.
• Employee Assistance Program with financial coaching and counseling resources.
• Professional development allowance and opportunities for internal career growth.
• Inclusive and collaborative culture with employee resource groups and community initiatives.