RCM Customer Service Specialist

Key Responsibilities

• Manage inbound and outbound inquiries related to dermatology billing via phone, secure email, and EMR-tasked messaging.
• Respond to patient calls and inquiries regarding charges, balances, payment arrangements, and EOB details with professionalism and empathy.
• Review and interpret Explanation of Benefits (EOBs) and remittance advice to determine patient responsibility and correct posting of payments.
• Verify patient demographics, insurance coverage, and eligibility as needed to resolve billing questions and prevent delays.
• Process and/or coordinate payment postings, refunds, adjustments, and write-offs in accordance with policy.
• Investigate claim denials and underpayments; identify root causes and communicate resolution steps to patients and internal teams.
• Collaborate with front desk, clinical staff, and coders to obtain required documentation or clarifications for billing questions.
• Resolve EMR-tasked billing items (e.g., billed-in-error notes, re-billing requests, pre-authorization/authorization tracking as applicable) with accuracy and timeliness.
• Communicate payment plans, balance notifications, and patient financial responsibility clearly and professionally.
• Maintain knowledge of dermatology-specific procedures, CPT/HCPCS codes, and associated payer rules relevant to the practice.
• Ensure compliance with HIPAA and all applicable privacy and security requirements during patient communications and data handling.
• Document interactions and resolutions in the Electronic Medical Record (EMR) and revenue cycle systems; maintain complete, accurate, and auditable notes.
• Escalate complex or unresolved issues to the appropriate supervisor or denials specialist in a timely manner.
• Contribute to process improvement by identifying trends in patient inquiries, denial patterns, and payment bottlenecks; propose enhancements to policies and workflows.
• Meet or exceed key performance indicators (KPIs) such as first-call resolution, average handle time, patient satisfaction scores, and denial/problem resolution rates.

Required Qualifications

• A high school diploma or equivalent; an associate degree or relevant certifications (e.g., HIM, CPC, CPAR, or revenue cycle certification) preferred.
• Proven experience in healthcare revenue cycle or medical billing/customer service, preferably in dermatology or outpatient specialty settings.
• A strong understanding of health insurance plans, benefit structures, network rules, copays/coinsurance/deductibles, and managed care terminology.
• A detailed knowledge of payment posting processes, coding basics (CPT/HCPCS/ICD-10), denials management, and Explanation of Benefits (EOBs).
• Experience handling EMR systems and billing tools; proficiency with payment posting, eligibility verification, and patient communication modules.
• Excellent verbal and written communication skills; ability to explain complex billing concepts in a patient-friendly manner.
• A knowledge of HIPAA requirements and a strong commitment to patient privacy and data security.
• The ability to work cross-functionally with front desk staff, clinical teams, and revenue cycle colleagues.

Preferred Qualifications

• Experience in dermatology or cosmetic dermatology revenue cycles.
• Knowledge of payer-specific rules for dermatology procedures, pre-authorization, and post-treatment billing.
• Bilingual abilities (e.g., English/Spanish) to support a diverse patient population.

Key Competencies

• Customer Service Excellence
• Revenue Cycle Knowledge
• Insurance & Benefit Literacy
• Denials & Remediation
• Communication Skills (verbal and written)
• Problem Solving and Critical Thinking
• Data Entry and Documentation Quality
• HIPAA Compliance
• Collaboration and Teamwork
• Time Management and Multitasking

Benefits

• Excellent Benefits Package (medical, dental, vision, 401K)
• 120 hours of Sick /Vacation time; Paid holidays
• Access to Care.com to support childcare, senior care, pet care, and other family needs.
• Exclusive discounts on select cosmetic services.

Pay

$66,300

Schedule

CORPORATE
Long Island City, NY