Job Title: RCM Specialist

Company: Kovo

Location: Remote

Job Description:

Kovo is seeking a highly skilled and experienced RCM Specialist to join our dynamic team. As a key member of our team, you will play a crucial role in submitting claims to payers, following up on denied or rejected claims and ensuring timely payments to maintain the provider’s cash flow and financial health. This role requires strong knowledge of billing, coding, and insurance regulations such as HIPAA.

Responsibilities:

• Manage accounts receivable for medical services, including insurance claims and patient payments.

• Set up and maintain payor portals for seamless claims submission and follow-ups.

• Work directly with clearinghouses to transmit claims and resolve issues related to claim rejections or denials.

• Ensure timely submission of insurance claims and follow up on unpaid or denied claims.

• Review patient accounts for accuracy, ensuring proper coding and billing procedures are followed.

• Communicate with insurance companies to resolve claim issues and ensure proper reimbursement.Work with patients to resolve billing inquiries and set up payment arrangements.

• Maintain accurate records of payments, adjustments, and outstanding balances.

• Monitor aging reports and take appropriate actions to reduce outstanding accounts.

• Stay current with insurance policies, billing codes, and any regulatory changes.Ensure compliance with HIPAA and other applicable regulations.

Qualifications:

• Previous experience in accounts receivable or medical billing, preferably podiatry experience.

• Knowledge of podiatry billing codes (ICD-10, CPT, HCPCS) and insurance reimbursement practices.

• Experience with A/R management, payment follow-ups, and claim resolutions.Experience setting up and managing payer portals and working within clearinghouses.

• Proficient in medical billing software and Microsoft Office.

• Strong analytical and organizational skills with attention to detail.

• Excellent communication skills, both written and verbal.

• Ability to multitask and work efficiently in a fast-paced environment.