Pacific RCM Solutions
Multi-specialty medical billing service.
A four-agent preset for medical-billing service companies - Operations Manager, Coder, Claims Specialist, Account Manager - wired with clearinghouse (Availity / Change Healthcare / Trizetto), practice-management systems (Kareo / AdvancedMD / NextGen), CAQH ProView, and the daily 837 / 835 / 277 EDI cadence that pays the practice.
Try it now
→ kwave.ai| Content | Count |
|---|---|
| Agents | 4 |
| Skills | 8 |
| Companies running this | 4 |
4 AI agents wired for this role. The CEO Dashboard is the hub; the rest report up to the CEO unless flagged owner-direct (escalation paths that bypass the CEO, like crisis routing).
| Agent | Role | Reports to |
|---|---|---|
| Operations Manager | Lead | owner-direct |
| Coder | Coding + Charge Entry | operations-manager |
| Claims Specialist | Submission + Follow-up | operations-manager |
| Account Manager | Client Reporting + Onboarding | operations-manager |
8 workflows the agents can run for you. Each is triggered by natural-language commands. The full SKILL.md (inputs, procedure, output format, write guards) is mounted in your workspace under .claude/skills/<slug>/ after install.
| Skill | Description |
|---|---|
| coding-charge-entry | Use when coding each encounter - reviews provider documentation, assigns ICD-10 / CPT / HCPCS codes, captures modifiers (25, 59, LT/RT), posts charges into Kareo / AdvancedMD / NextGen. |
| claim-scrubbing | Use when scrubbing claims pre-submission - runs the scrubber against payer-specific edits + NCCI / MUE rules, fixes errors before claims hit the clearinghouse. |
| claim-submission | Use when running daily claim submission - submits 837 batches via Availity / Change Healthcare / Trizetto, tracks 277CA acceptance, handles rejections same-day. |
| denial-management | Use when working the daily denial queue - categorizes denials by CARC / RARC codes, drafts appeals (CO-50, CO-97, CO-22), tracks recovery rate per payer. |
| era-posting | Use when ERAs land from payers - auto-posts 835 payments to claims, surfaces underpayments + contract variance, flags zero-pays for follow-up. |
| patient-statements | Use when running monthly patient statements - generates statements after primary + secondary, runs payment plans, hands off 120+ aging to collections agency. |
| client-reporting | Use when generating monthly client reports - A / R aging by bucket, collection ratio, denial reasons, top performers per provider, sent to client practice. |
| credentialing-tracking | Use when tracking payer enrollment, CAQH ProView attestations, re-credentialing deadlines (every 3 years), provider NPI / DEA updates. |
Public listings only — opted in by the company. 4 companies below.
Create a company in KWAVE and the full Medical Billing Service preset above runs in your workspace from day one - all 4 AI agents and 8 skills, wired and ready.
Detailed workflow guides for each skill live inside the workspace dashboard. Sign up at kwave.ai to access them.