RCM Specialist II

Department: Revenue Cycle ManagementReports to: Senior Manager of Revenue CyclePay Group: Non-ExemptDo you love solving puzzles and making processes work better? Join our team as an RCM Specialist II, where you'll play a vital part in ensuring our laboratory services are reimbursed fully and on time. You'll dive into denied and rejected insurance claims, identify the causes, and drive resolutions that help support our mission of delivering exceptional care.Your knack for research, collaboration, and follow-through will help streamline the revenue cycle—and your contributions will make a real impact!What You'll DoOwn the process of gathering and reviewing all claim information to guarantee accurate and timely submissions.Work closely with teammates across billing and clinical teams to obtain missing data or clarify any discrepancies.Analyze denied and rejected claims to identify the root cause and correct errors efficiently.Submit appeals and adjustments that maximize reimbursement in accordance with insurance guidelines.Reach out to payers directly to resolve outstanding claims, update information, and advocate for prompt payment.Follow up on underpaid or unpaid claims and ensure we’re capturing every dollar we deserve.Monitor accounts for credit balances and process timely, compliant refunds.Spot trends—share patterns of denials or delays with leadership so we can proactively tackle recurring issues.Keep your knowledge sharp as you stay up to date on payer policies, coding changes, and lab-specific regulations.Safeguard patient information and ensure HIPAA compliance in every interaction.What We’re Looking ForExcellent communication skills (both written and verbal)Super strong attention to detail and organizationAbility to thrive in a fast-paced fast changing environmentAnalytical mindset and problem-solving driveCommitment to exceptional customer serviceProficiency with Microsoft Office and other electronic health or billing platformsFamiliarity with claims processes, coding basics, and industry-specific best practicesPreferred QualificationsPrior experience handling claims denials and appealsMedical coding certification or lab industry background preferredFamiliarity with TELCOR and electronic billing systems2+ years of claims processing and/or relevant certification (e.g. CRCR, CPC)High school diploma or equivalent required; some college preferredPhysical RequirementsExtended periods of sitting and computer useExtended periods of talking, listening and typing while on a phoneWhy Join Us?You’ll be part of a collaborative, supportive team committed to improving healthcare every day. This is a place where your expertise truly matters — we can’t wait for you to grow with us!Gravity Diagnostics is an Equal Opportunity Employer. All persons shall have the opportunity to be considered for employment without regard to their race, color, religion, national origin, ancestry, alienage or citizenship status, age, sex, gender, gender identity, gender expression, sexual orientation, marital status, disability, military service and veteran status, pregnancy, childbirth, and related medical conditions, or any other characteristic protected by applicable federal, state or local laws.Gravity Diagnostics will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business.