Illinois Licensed RCM Claims Specialist

Job Summary

Managing outstanding insurance and patient accounts, the full-time Illinois Licensed RCM Claims Specialist will work remotely to resolve claims issues, drive account resolution, and ensure timely reimbursements while adhering to productivity and quality standards.

Key responsibilities

• Review and manage assigned accounts receivable inventory, analyzing unpaid, underpaid, and denied claims
• Investigate denial trends, submit appeals, and escalate recurring issues to leadership as needed
• Collaborate with internal teams to communicate account issues and maintain compliance with payer regulations and company policies

Required qualifications

• High School Diploma or GED required
• 3-5 years of experience in vision medical billing, accounts receivable, collections, or denial management
• Experience with commercial, Medicare, Medicaid, and vision insurance preferred
• Knowledge of EOBs, ERA remittances, claim appeals, and payer follow-up processes
• Proficient in Microsoft Office, particularly Excel