RCM Staff LLC

Medical Biller

• Review encounters and charges for accuracy before claim submission
• Submit clean claims through the practice management system and clearinghouse
• Work clearinghouse and payer rejections and resubmit corrected claims
• Follow up on unpaid and underpaid claims through payer portals and phone calls
• Research denials, correct and resubmit claims, and prepare appeals when needed
• Post insurance payments and adjustments from ERAs and EOBs
• Verify CPT, HCPCS, and ICD-10-CM codes against documentation and payer rules
• Work aging A/R reports and prioritize accounts by age and dollar value
• Document all account activity clearly in the billing system
• Protect patient information and follow HIPAA requirements
• Support day-to-day billing for a multi-provider outpatient mental health practice, from claim submission through payment and denial follow-up

Behavioral Health Medical Biller – Part-time

Credentialing Specialist

• Prepare and submit initial payer enrollment applications for individual providers and group practices for commercial and government plans
• Complete, update, and attest CAQH ProView profiles and keep supporting documents current
• Maintain provider records in PECOS and NPPES, including revalidations, reassignments, and demographic changes
• Track pending applications and follow up with payer provider relations by phone, portal, and email until effective dates are confirmed
• Manage the recredentialing and revalidation calendar to prevent provider lapses with payers
• Collect and maintain credentialing documents, including state licenses, DEA registrations, malpractice certificates of insurance, board certifications, W-9s, and CVs, and track expiration dates
• Submit roster updates, group additions and terminations, and demographic changes to payers
• Document every application, payer contact, reference number, and effective date in the client’s credentialing tracker
• Provide a weekly status report to the client contact and escalate stalled or denied applications
• Protect patient information and follow HIPAA requirements

Credentialing and Payer Enrollment Specialist – Part-time

• Review completed visits and submit clean claims to insurance payers through IntakeQ (PracticeQ) and the clearinghouse
• Verify patient eligibility and benefits before visits and flag coverage issues to the practice
• Post insurance payments, adjustments, and patient payments from ERAs and EOBs
• Work claim rejections and denials, correct and resubmit claims, and file appeals when appropriate
• Follow up on unpaid and aging claims with payers by portal and phone
• Track authorizations and visit limits for behavioral health services and alert the practice before they run out
• Prepare and send patient statements and respond to patient billing questions professionally
• Keep billing notes and account activity documented so the practice and RCM Staff can review status at any time
• Report weekly on claims submitted, payments posted, open denials, and outstanding A/R
• Protect patient information and follow HIPAA requirements

Medical Biller, Part-time – Behavioral

• Handle prior authorizations for surgical cases
• Verify patient eligibility and benefits
• Submit claims and ensure clean claims are sent
• Work denials and accounts receivable
• Post payments
• Obtain authorization approval before surgical cases
• Resolve denied or unpaid claims
• Support a single-provider orthopedic spine surgery practice
• Manage multiple patient accounts independently
• Communicate with payers and patients by phone

Behavioral Health Medical Biller – Part-time

Credentialing and Payer Enrollment Specialist – Part-time

Medical Biller, Part-time – Behavioral

Medical Biller – Orthopedic