Rcm eligibility specialist Job at Robert Half (Houston)

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

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Rcm eligibility specialist

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