Job Description

Description POSITION: RCM AR Specialist II RESPONSIBLE TO: RCM Supervisor, AR Collections JOB SUMMARY: Follows up on Claim Denials and overdue insurance balances using Explanation of Benefits (EOB) documents and reports. RCM AR Specialist are assigned specific book of business based on Financial Class and Payers. Work to support the field related to claim denials. RESPONSIBILITIES INCLUDE, BUT ARE

A Day in the Life: Denial Management

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7:30 AM

Log in and pull the overnight denial queue. Your worklist shows 40–80 claims flagged by the payer in the last 24 hours. Sort by do…

8:00 AM

Start working the queue. For each denial, you're reading the remittance advice, identifying the denial reason code (CO-4, CO-50, C…

9:30 AM

Hit a complex medical necessity denial from a Medicare Advantage plan. Open the patient chart, pull the clinical documentation, an…

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