<p>We are seeking a detail-oriented and experienced <strong>RCM Eligibility Specialist</strong> to join our team on a <strong>contract-to-hire</strong> basis. This <strong>fully remote</strong> position plays a critical role in ensuring the timely and accurate financial clearance of patient accounts.</p><p>The ideal candidate thrives in a fast‑paced environment, is meticulous in their work, and has a strong background in eligibility verification, claim error resolution, and clean claim submission.</p><p><br></p><p><strong>Responsibilities</strong></p><p><strong>1. Eligibility Verification</strong></p><ul><li>Conduct thorough reviews of patient insurance coverage and benefit eligibility for laboratory services.</li><li>Communicate with teammates, clinics, patients, and insurance companies to verify coverage and resolve discrepancies.</li><li>Accurately document eligibility information within the revenue cycle management system.</li></ul><p><strong>2. Claim Error Processing</strong></p><ul><li>Analyze and resolve claim errors identified by the RCM system, including coding and billing discrepancies.</li><li>Collaborate with teammates to resolve errors and ensure compliance with internal policies and procedures.</li><li>Identify and resolve issues related to medical necessity.</li><li>Perform other duties as assigned.</li></ul>

<p><strong>Qualifications</strong></p><ul><li>College degree preferred, or equivalent experience (5+ years).</li><li>Minimum of <strong>5 years of experience</strong> in medical billing, eligibility verification, or financial clearance.</li><li>Strong understanding of HIPAA regulations and proper handling of protected health information (PHI).</li><li>Working knowledge of insurance policies, billing procedures, and claim terminology.</li><li>Excellent communication and interpersonal skills.</li><li>Highly detail‑oriented with strong analytical and problem‑solving abilities.</li><li>Preferred experience with laboratory billing platforms such as <strong>Telcor, Xifin, or Quadax</strong>.</li></ul><p><br></p><p><strong>Skills</strong></p><ul><li>Strong knowledge of insurance guidelines, CPT/ICD‑10 coding, and medical terminology.</li><li>Exceptional attention to detail and time management.</li><li>Strong communication and problem‑solving skills.</li><li>Proficiency with Microsoft Office and healthcare software tools.</li></ul>

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