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Rcm eligibility specialist

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Robert Half

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Location:
United States , Houston

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Category:
Health and Beauty

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Contract Type:
Not provided

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Salary:

Not provided
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Job Description:

We are seeking a detail-oriented and experienced RCM Eligibility Specialist to join our team on a contract-to-hire basis. This fully remote position plays a critical role in ensuring the timely and accurate financial clearance of patient accounts. 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.

Job Responsibility:

  • Conduct thorough reviews of patient insurance coverage and benefit eligibility for laboratory services
  • Communicate with teammates, clinics, patients, and insurance companies to verify coverage and resolve discrepancies
  • Accurately document eligibility information within the revenue cycle management system
  • Analyze and resolve claim errors identified by the RCM system, including coding and billing discrepancies
  • Collaborate with teammates to resolve errors and ensure compliance with internal policies and procedures
  • Identify and resolve issues related to medical necessity
  • Perform other duties as assigned

Requirements:

  • College degree preferred, or equivalent experience (5+ years)
  • Minimum of 5 years of experience in medical billing, eligibility verification, or financial clearance
  • Strong understanding of HIPAA regulations and proper handling of protected health information (PHI)
  • Working knowledge of insurance policies, billing procedures, and claim terminology
  • Excellent communication and interpersonal skills
  • Highly detail‑oriented with strong analytical and problem‑solving abilities
  • Preferred experience with laboratory billing platforms such as Telcor, Xifin, or Quadax
  • Strong knowledge of insurance guidelines, CPT/ICD‑10 coding, and medical terminology
  • Exceptional attention to detail and time management
  • Strong communication and problem‑solving skills
  • Proficiency with Microsoft Office and healthcare software tools
What we offer:
  • medical, vision, dental, and life and disability insurance
  • eligible to enroll in our company 401(k) plan

Additional Information:

Job Posted:
February 20, 2026

Work Type:
Remote work
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