RCM - Patient Billing Specialist

RCM - Patient Billing Specialist

Location:

Draper, UT (on-site)

Department:
Revenue Cycle Management

Reports To:

RCM Supervisor / Billing Manager Position Summary The RCM Patient Communications Specialist is responsible for handling escalated patient billing scenarios as well as proactively reaching out to patients to provide updates on their billing inquiries. This role serves patients receiving evaluation and management (E&M) and DME services related to sleep apnea care, including but not limited to office visits, sleep studies, and ongoing supply orders.

The Specialist must understand how care delivery and order fulfillment connect to the charges patients see on their statements, communicate that clearly and calmly to patients, and coordinate with other teams as needed to ensure billing aligns with the patient's actual course of care. This role also supports the RCM team by working directly with insurance payers to resolve and overturn claim denials so patient claims are paid appropriately.

Key Responsibilities Escalated Patient Communication Handle escalated patient billing scenarios, as well as outbound outreach to patients to provide updates on the status of their billing inquiries

Return patient callsregardingbalances, statements, and billing disputes, and work to resolve themin a timely manner consistent with company expectations

De-escalate frustrated or confused patients by listening actively and responding with empathy

Explain charges, insurance adjustments, and balances in plain, easy-to-understand language, including how services and supply orders factor into a patient's total balance

Collect patient cost share (e.g., copays, coinsurance, deductibles) associated with their claims

Document all patient interactions and resolutions accurately in the appropriate system(s)
Identify recurring issues or trends in inquiries and report them to leadership

Cross-Functional Coordination Work with other internal teams as needed to verify that billed charges correctly reflect servicesrenderedand orders fulfilled

Investigate discrepancies between a patient's account history and their billed balance before contacting the patient

Escalate any underlying operational issues contributing to billing discrepancies to the appropriate team Payer & Claims Support

Contact insurance companies to research and resolve claim denials

Prepare andsubmitappeals to overturn denials so patient claims are paid appropriately

Coordinate with billing and coding teams to gather documentation needed for appeals

Track denial and appeal status to ensuretimelyfollow-up and resolutionQualifications

Required High school diploma or equivalent;

Associate'sdegree preferred1+ years of experience in medical billing, patient collections, or healthcare customer service

Strong verbal communication and conflict-resolution skills

Ability to explain complex billing information in a clear, patient-friendly manner

Comfortable working with insurance payers on denials and appeals

Ability to manage and resolve escalated cases ina timely, organized manner

Must be able to work on-site in Draper, UTPreferred

Experience with Salesforce,Niko Health, andathena

One(Athena)

Experience with other EMR/practice management platforms

Experience in sleep medicine or DME billing

Core Competencies Empathy and patience under pressure

Clear, professional communication (verbal and written)

Cross-team collaboration and investigative problem-solving

Attention to detail across billing and account data Strong time management and prioritization skills

Compensation details: 20-25 Yearly Salary

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