Virtual Revenue Cycle Management (RCM) Specialist - Provider Side

Job Summary:

MedVA is looking for a dedicated and skilled Virtual RCM Specialist to enhance our client's revenue cycle management operations. As a Virtual RCM Specialist, you will be responsible for overseeing various aspects of the revenue cycle, from patient registration to final payment. Your expertise will ensure optimal revenue collection and compliance with healthcare regulations while enhancing the overall financial processes.

Key Responsibilities:

Billing & Claims Management

• Submit accurate and timely claims to insurance companies (commercial, Medicare, Medicaid).
• Verify patient insurance eligibility and benefits before services are rendered.
• Ensure correct coding using CPT, ICD-10, and HCPCS codes to prevent denials.

Payment Posting & Reconciliation

• Post payments from insurance providers and patients into the system.
• Reconcile discrepancies in payments and address underpayments.

Denial & Appeals Management

• Analyze denied claims, determine root causes, and submit timely appeals.
• Communicate with payers to resolve claim issues and secure reimbursements.

Patient Financial Coordination

• Manage patient statements, outstanding balances, and payment plans.
• Educate patients on their financial responsibilities, including deductibles and copays.

Compliance & Reporting

• Ensure adherence to HIPAA regulations, payer guidelines, and industry standards.
• Generate and analyze RCM reports (e.g., A/R aging, collection rates, denial trends).

Collaboration:

Work closely with providers, payers, and internal teams to improve revenue cycle efficiency.

Requirements

Education: Bachelor’s degree in Healthcare Administration, Finance, or related field (preferred).

Experience: 1+ years in RCM, medical billing, or provider-side revenue cycle.

Technical Skills:

• Experience with EHR/EMR systems (Epic, AthenaHealth, eClinicalWorks, Kareo, etc.).
• Proficiency in medical billing software and Microsoft Office (Excel, Word).
• Ability to analyze financial data and provide insights for better revenue management.

Certifications (Preferred but Not Required):

• Certified Professional Coder (CPC)
• Certified Medical Reimbursement Specialist (CMRS)
• Certified Revenue Cycle Representative (CRCR)

Soft Skills:

• Excellent analytical skills and attention to detail, with the ability to manage time effectively.
• Strong communication and organizational skills.
• Ability to work both independently and collaboratively in a team environment.

Benefits

• Permanent work from home set up

• Getting paid more than the average local pay rates in the comfort of your own home!
• Competitive Hourly rate
• As an Independent Contractor, we offer competitive market rates!
• Retirement savings plan**
• Saving money can be challenging so we will do it for you! We will make sure that at the end of the day, you'll get something out of your hard work.
• Quality Training
• MedVA provides continuous learning at ZERO cost. We take great pride in the quality of our training program and believe that the best way to learn is to gain knowledge from the experts themselves. 

**Eligibility is based on tenure.