RCM Specialist

CWG/Blended HealthPlano, TX
23hHybrid

About The Position

Revenue Cycle Management (RCM) Specialist supports efficient and accurate billing and collections processes by proactively monitoring patient accounts, particularly for same-day appointments, and generating daily reports for Care Navigators that outline outstanding prior balances and current patient responsibility amounts due at the time of service. This hybrid role requires onsite presence 1–2 times per week, depending on location. The RCM Specialist monitors and analyzes daily collection activity from Care Navigators, identifying collection trends, gaps, and opportunities for process improvement across clinic locations and Care Navigators. The role also oversees declined payments, terminated payment plans, and balance increases through proactive multi-channel outreach (phone, text, and email), escalating unresolved accounts with structured follow-up plans. Additionally, the RCM Specialist assists patients/guarantors and Care Navigators with billing inquiries or concerns and supports Financial Counselors with insurance benefit verifications.

Requirements

  • High school diploma or GED required. Bachelor’s degree in business, Finance, or a related field preferred.
  • 3+ years of related work experience in healthcare admissions, finance, insurance, customer service, claims, billing or collections, or call center roles.
  • Excellent customer service and communication skills (verbal and written). Comfortable delivering information and answering questions on camera as well as over the phone.
  • Ability to manage multiple software applications simultaneously while communicating via phone or chat.
  • Familiarity with software applications like Microsoft Office Suite, Microsoft Word, Excel, Outlook, Teams, Zoom or other virtual platforms.
  • Basic troubleshooting skills for minor technical issues.
  • Strong problem-solving skills and a commitment to maintaining financial accuracy.
  • Flexibility to adapt to changing priorities, technology, and business needs.
  • Ability to remain calm and effective in emergencies.
  • Strong understanding of confidentiality requirements regarding patient information.
  • Strong mathematics, organizational, and attention-to-detail skills.
  • Ability to sit for long periods of time (8-10 hours).
  • Ability to reach above and below the waist, turn, twist and to manipulate small tools (copier, computer, telephone, keyboard, calculator, safe, facsimile machine).
  • Ability to read and interpret handwritten and printed materials.
  • Ability to handle a variety of repetitive tasks at a moderate level.
  • Available to work varied hours, including some evenings when required.
  • Ability to manage multiple projects and tasks and meet established deadlines, including assignments with limited notice.
  • All candidates must be able to pass a pre-employment drug screen and be willing to submit to a national background check.

Nice To Haves

  • Experience is preferred with call center software systems such as Salesforce, VCC (Vonage Contact Center), Paymentus, Care Credit, CollabMD, Kipu, EMRs/EHRs, and insurance portals.
  • Familiarity with outpatient mental health settings and services preferred.
  • Basic understanding of behavioral health terminology.
  • Knowledge of medical billing practices, office policies, and procedures.

Responsibilities

  • Monitor patient accounts for individuals with same-day appointments and generate daily reports for Care Navigators outlining prior balances and current patient responsibility due at time of service.
  • Support Care Navigators with patient account inquiries and point-of-service collection guidance.
  • Analyze daily collections activity across clinic locations to identify collection trends, gaps, and opportunities for process improvement.
  • Oversee and actively manage Declined Payment, Payment Plan Termination, and Balance Increase patient lists on a weekly basis.
  • Conduct proactive multi-channel outreach (phone, text, and email) to resolve outstanding balances.
  • Assist Care Navigators, patients and guarantors with billing questions, payment concerns, and account resolution.
  • Act as a point of contact for vendor inquiries regarding billing, coding, and operational updates.
  • Monitor chat platforms to offer real-time support and guidance to vendors and internal teams as needed.
  • Respond to inquiries in a timely manner and escalate issues with the manager when necessary.
  • Open, organize, and process incoming mail related to financial operations, billing, and payments on a weekly basis.
  • Prepare and facilitate accurate and timely bank deposits, weekly.
  • Assist Financial Counselors with insurance benefit verification and related billing support tasks.
  • Maintain accurate documentation of collection activity and ensure compliance with organizational policies and billing regulations.
  • Collaborate with other organizational members to resolve discrepancies or disputes regarding patient billing information or patient financials.
  • Act as a liaison between multiple departments, including Utilization Review, Contact Center, Care Navigators, Executive Directors, RCM, and CGS (offshore team).
  • Adhere to all federal and state healthcare regulations.
  • Employees may be required to attend initial onboarding, training sessions, and periodic meetings on-site. In addition, on-site presence may be necessary to process incoming mail and checks. These in-office requirements may occur on a weekly basis.
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