RCM - Patient Billing Specialist

Location: Draper, UT (on-site)

About the Role

The RCM Patient Communications Specialist handles escalated patient billing scenarios and proactively reaches out to patients to provide updates on their billing inquiries. This role serves patients receiving evaluation and management (E&M) and DME services related to sleep apnea care, including office visits, sleep studies, and ongoing supply orders. The Specialist ensures billing aligns with the patient's actual course of care and supports the RCM team by resolving and overturning claim denials with insurance payers.

Responsibilities

• Handle escalated patient billing scenarios, including outbound outreach to provide updates on billing inquiries.
• Return patient calls regarding balances, statements, and billing disputes, resolving them in a timely manner.
• De-escalate frustrated or confused patients by listening actively and responding with empathy.
• Explain charges, insurance adjustments, and balances in plain language, including how services and supply orders factor into a patient's total balance.
• Collect patient cost share (e.g., copays, coinsurance, deductibles) associated with their claims.
• Document all patient interactions and resolutions accurately in the appropriate system(s).
• Identify recurring issues or trends in inquiries and report them to leadership.
• Work with internal teams to verify billed charges reflect services rendered and orders fulfilled.
• Investigate discrepancies between a patient's account history and their billed balance before contacting the patient.
• Escalate operational issues contributing to billing discrepancies to the appropriate team.
• Contact insurance companies to research and resolve claim denials.
• Prepare and submit appeals to overturn denials so patient claims are paid appropriately.
• Coordinate with billing and coding teams to gather documentation needed for appeals.
• Track denial and appeal status to ensure timely follow-up and resolution.

Requirements

• High school diploma or equivalent; Associate's degree preferred.
• 1+ years of experience in medical billing, patient collections, or healthcare customer service.
• Strong verbal communication and conflict-resolution skills.
• Ability to explain complex billing information in a clear, patient-friendly manner.
• Comfortable working with insurance payers on denials and appeals.
• Ability to manage and resolve escalated cases in a timely, organized manner.
• Must be able to work on-site in Draper, UT.

Preferred Qualifications

• Experience with Salesforce, NikoHealth, and athenaOne (Athena).
• Experience with other EMR/practice management platforms.
• Experience in sleep medicine or DME billing.

Skills

• Empathy and patience under pressure.
• Clear, professional communication (verbal and written).
• Cross-team collaboration and investigative problem-solving.
• Attention to detail across billing and account data.
• Strong time management and prioritization skills.

Pay

$20–25 yearly salary.