Revenue Cycle Specialist

Job Description

The Revenue Cycle Specialist is a vital aspect of our billing team who is responsible for daily billing/submissions of claims, correcting and monitoring rejections, third-party follow-up, and reviewing payments posted, among other duties. Essential to this position is the ability to communicate clearly and concisely, verbally and in writing, establish and maintain long-term customer relationships, building trust and respect by consistently meeting and exceeding expectations.

• Validate all pertinent treatment information in order to submit accurate claims.

• Ensure all patient demographics and payer information are accurate

• Submit all claims to clearing house and work rejections, as needed.

• Communicates directly with the payor, resubmits denied claims, underpaid claims and claims that are inaccurately processed. Receives the denied claims and researches appropriate steps.

• Run reconciliation to ensure completion of open tasks.

• Prepares, posts, verifies, and records customer payments and transactions

• Identifies delinquent accounts by reviewing files and reports delinquent account holders.

• Review posted payments for reimbursement according to contract and accuracy

• Provide effective communication to patient/family, team members, and other health care professionals and maintain confidentiality.

• Review payer contracts to ensure billing and reimbursement compliance and accuracy

• Ensure that all patient accounts are properly and completely documented

• Assists the Accounting Department in reconciling revenue accounts.

• Collaborates with necessary departments in order to drive process improvement

• Relays changes of information to appropriate employees and leaders.

• Investigate and resolve customer queries

Qualifications:
Qualifications

• Education: Associate’s or Bachelor’s degree in Accounting preferred.
• Experience: A minimum of 2 years in revenue cycle, claims, or medical billing preferred
• Excellent communication, organization, attention to detail, and problem solving skills.
• Proficient in Google Workspace as well as other accounting software programs.
• Detailed understanding of healthcare insurance processes, including resolving non-paid, denied, underpaid, and rejected claims.
• Ability to work independently and in a fast-paced environment.
• Ability to anticipate work needs and interact professionally with employees and leaders.
• Excellent organizational skills and attention to detail.
• Demonstrate excellent problem-solving and negotiating skills.
• Ability to sustain prolonged sitting and extended computer use. Requires hand-eye coordination and manual dexterity.

Additional Information

All your information will be kept confidential according to EEO guidelines.