Jobs · OTHR · New Mexico

RCM Specialist

The Blue Venture Fund · Albuquerque, NM · 2 wk ago
OTHR$25/hrFull-time

Workit Health is an industry-leading provider of on-demand, evidence-based telemedicine care. Our programs are based in harm reduction, and bring together licensed clinicians who really listen, FDA-approved medication, online recovery groups and community, interactive therapeutic courses, and care for co-existing conditions. Workit Health's patient-centered telemedicine model is improving clinical outcomes and eliminating barriers to treatment, making long-term recovery accessible to individuals who need it, without disrupting their daily lives.

About the role

Workit Health is seeking a full-time RCM Specialist to work rejections and denials as they come in and escalate any denial or rejection trends as they are identified. The ideal candidate has experience billing for addiction medicine and/or outpatient medication-assisted treatment or experience in billing for telemedicine services. Experience with calling health insurance plans is a must. Candidates will demonstrate patient and empathetic communication to our members, be able to work accounts promptly, and be open to workflow changes. Workit Health is a fast-paced, fluid environment where changes are frequent and employee input is highly valued.

Responsibilities

  • Proficient in medical software, insurance websites, and EHR systems (Elation or Candid preferred)
  • Verify patient eligibility and benefits including coordination of benefits
  • Identify and resolve claims processing issues, including pre-submission errors, and generate appeals or reprocess claims as needed
  • Communicate effectively with patients, physicians, management, staff, and third-party representatives
  • Contact insurance payers for eligibility, claims resolution, and authorization requests
  • Submit medical records to insurance when needed
  • Review and audit patient accounts for accuracy
  • Maintain compliance with professional standards, company policies, and federal, state, and HIPAA regulations
  • Manage a high volume of claims, calls, chats, and tasks while meeting productivity and quality standards
  • Respond promptly to all calls, chats, and voicemails during business hours
  • Maintain a positive and optimistic attitude
  • Ensure timely completion of daily tasks
  • All other duties as assigned

Requirements

  • 1-2 years previous Medical Billing experience
  • CPC or CPB certification a plus but not required
  • Payment Posting experience a plus but not required
  • Must be able to work independently and rely on personal knowledge/experience for problem-solving
  • Must have experience with MS Word and Google Sheets or MS Excel
  • Must be detail-oriented and have excellent organizational and time management skills
  • Must excel at providing a high level of customer service and be able to work in a team environment
  • Requires strong analytical skills and attention to detail, including writing and verbal communication skills and a professional positive attitude

Schedule

  • Monday–Friday, 8:00 AM – 4:30 PM local time
  • Hybrid schedule: Monday–Wednesday in office and Thursday–Friday remote each week

Pay

$25—$25 USD per hour

Benefits

  • Fully remote work
  • 5 weeks PTO (includes your birthday, 2 mental health days, and 2 floating holidays)
  • 11 paid holidays
  • Comprehensive health, dental, pharmacy, and vision insurance with options to fit your family's needs
  • 12 weeks paid Parental Leave after 1 year of employment (includes maternity, paternity, adoption, and all ways in which our people build modern families)
  • 401k + 4% matching
  • Healthcare & dependent care Flexible Spending Accounts (FSA & DCFSA)
  • Health Savings Accounts (HSA)
  • Employee assistance program, complete with financial coaching and counseling sessions
  • Professional development allowance for Providers and Behavioral Health team
  • Opportunities for internal mobility and growth at a Company with a proven track record of promoting internally
  • Vibrant, democratized culture with clubs and multiple ERG groups
  • Colleagues who care deeply about closing health disparity gaps within the addiction space for underserved populations

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