{"id":1146458,"url":"https://alion.io/job/netsmart-technologies-rcm-accounts-receivable-specialist-medical-billing-experience","title":"RCM Accounts Receivable Specialist- Medical Billing Experience","company":{"id":37377,"name":"Netsmart Technologies","domain":"ntst.com","url":"https://alion.io/company/netsmart","size_band":"1001-5000","is_staffing_agency":false,"is_intermediary":false,"ats_vendor":"Workday","truth_index":{"grade":"A","score":100,"open_postings":6,"ghost_share":0,"stale_share":0,"repost_share":0,"time_to_fill_p50_days":16,"computed_at":"2026-09-23T05:45:00Z"}},"role":"Finance","role_family":"Finance","seniority":"junior","employment_type":"full_time","work_mode":"remote","remote_scope":"stated_countries","hiring_geo_confidence":"explicit","locations":["United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":null,"salary_estimate":{"min_usd":49000,"max_usd":99000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":94},"experience_years_min":1,"visa_sponsorship":true,"relocation_package":false,"has_equity":false,"technologies":[{"name":"Microsoft Excel","optional":false},{"name":"Outlook","optional":false}],"status":"live","first_seen_at":"2026-09-23T15:23:47Z","employer_posted_date":"2026-09-23","last_verified_at":"2026-09-22T22:25:44Z","board_verified":true,"closed_at":null,"days_open":0,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":0},"description":"Job Summary\nThe RCM Accounts Receivable Specialist is responsible for resolving outstanding insurance accounts receivable through proactive follow-up, denial management, appeals, and payer communication. This role focuses on maximizing reimbursement, identifying denial trends, and driving revenue cycle performance improvements for assigned client accounts.\nSuccess in this role requires strong analytical skills, a deep understanding of healthcare reimbursement processes, and extensive daily use of Microsoft Excel and Outlook to manage account inventories, communicate with payers, track claim activity, and analyze denial trends.\nResponsibilities\nManage a portfolio of outstanding insurance accounts receivable, ensuring timely follow-up and resolution of unpaid or underpaid claims.\nPerform end-to-end denial management, including researching claim denials, identifying root causes, submitting appeals, and securing appropriate reimbursement.\nAnalyze denial patterns and reimbursement trends to identify opportunities for process improvement and revenue recovery.\nContact insurance carriers via phone, email, fax, payer portals, and written correspondence to resolve claim issues and payment delays.\nInvestigate and resolve claim edits, rejections, authorization issues, coding discrepancies, and payer-specific reimbursement concerns.\nFollow up on aged accounts and claims with no response from insurance carriers while maintaining productivity and quality standards.\nUtilize Microsoft Excel to track accounts, analyze payer trends, manage work queues, create reports, and maintain denial inventories.\nUtilize Microsoft Outlook extensively for communication with payers, clients, and internal stakeholders regarding claim resolution activities.\nReview and apply current federal, state, Medicare, Medicaid, and payer-specific billing regulations.\nHandle Electronic Data Interchange (EDI) transactions, including reconciliation of carrier submissions, clearinghouse edits, and rejection reports.\nLeverage RPA tools and AI-assisted workflows to enhance efficiency, automate routine follow-up activities, and improve claim resolution outcomes.\nMaintain detailed documentation of account activity and claim resolution efforts.\nRequired Qualifications\nHigh school diploma or GED.\nMinimum of 1 year of healthcare accounts receivable, medical billing, or denial management experience.\nDemonstrated experience researching and resolving insurance claim denials and payer reimbursement issues.\nAdvanced Microsoft Excel skills, including VLOOKUPs/XLOOKUPs, Pivot Tables, filters, formulas, and spreadsheet management.\nStrong proficiency in Microsoft Outlook, including managing high-volume email communications and claim follow-up correspondence.\nUnderstanding of insurance reimbursement processes, claim adjudication, Medicare, Medicaid, and commercial payer requirements.\nStrong analytical, critical thinking, and problem-solving skills.\nExcellent verbal and written communication skills.\nDemonstrated ability to manage productivity metrics and work independently in a fast-paced environment.\nPreferred Qualifications\nExperience in behavioral health, post-acute care, home health, long-term care, or specialty healthcare billing.\n2+ years of insurance AR follow-up and denial management experience.\nCollections experience within a healthcare revenue cycle environment.\nExperience preparing and submitting formal appeals to insurance carriers.\nWorking knowledge of medical billing systems such as Medic, IDX, Avatar, Tier, Medical Manager, or similar platforms.\nExperience with automation tools, AI-enabled workflows, or revenue cycle technology solutions.\nNetsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all individuals. We celebrate diversity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.\nNetsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmart’s sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the individual can provide proof of valid prescription to Netsmart’s third party screening provider.\nIf you are located in a state which grants you the right to receive information on salary range, pay scale, description of benefits or other compensation for this position, please use this form to request details which you may be legally entitled.\nAll applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work visa sponsorship for this position.\nNetsmart's Job Applicant Privacy Notice may be found here.","description_format":"text","description_chars":5546,"description_truncated":false,"requirements":{"experience_years_min":1,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":{"level":"high_school","optional":false},"security_clearance":false,"languages":[]},"benefits":[],"hiring_locations":[{"name":"United States","iso":"US","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Health Care","Mental Health","Dental Care"],"lifecycle":[{"event":"open","at":"2026-09-23T15:23:47Z"}],"liveness":{"score":86,"band":"hot","label":"Hiring now","p_open":1,"p_active":0.86,"p_room":1,"age_days":0,"expected_fill_days":16,"reasons":["conf:7","win:early","comp:junior"],"computed_at":"2026-09-23T22:59:04Z"},"pay":null,"html_url":"https://alion.io/job/netsmart-technologies-rcm-accounts-receivable-specialist-medical-billing-experience","json_url":"https://alion.io/job/netsmart-technologies-rcm-accounts-receivable-specialist-medical-billing-experience.json","meta":{"generated_at":"2026-09-23T22:59:04Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers"}}