Rcm Specialist

 

Description:

MetaCare is hiring an experienced RCM Specialist who can independently manage both the Production (Charge Entry & Claim Creation) side and the Accounts Receivable (AR) side of US Medical Billing.

 

We are looking for someone who understands the complete revenue cycle — from charge entry to payment posting and denial resolution — and can take ownership of claims from start to finish.

 

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Key Responsibilities:

 

Production Side:

• Accurate charge entry from encounter forms / superbills

• Claim creation and timely submission (electronic & paper)

• CPT, ICD-10, HCPCS code review with correct modifiers

• Insurance verification before claim submission

• Clearinghouse management (rejections, edits, resubmissions)

• Maintain high clean-claim rate

 

Accounts Receivable (AR) Side:

• Follow up on unpaid and denied claims

• Work on denial management and appeals

• Identify root causes of denials and implement corrections

• Insurance calls and portal follow-ups

• Maintain AR aging within targets

• Ensure maximum and timely reimbursements

 

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Requirements:

• Minimum 2–3 years of experience in US Medical Billing (Production + AR both required)

• Strong knowledge of CPT, ICD-10, HCPCS, and modifiers

• Experience with clearinghouses (Office Ally, Availity, etc.)

• Strong understanding of denial codes and payer guidelines

• Ability to meet production and AR KPIs

• Strong analytical and communication skills

• Ability to work independently and take ownership