Revenue Cycle Specialist

Overview

The Revenue Cycle Specialist's primary responsibility is the assurance of Medicaid policies & procedures across all Arrow services. These processes will inform and improve practices that have a direct impact on services to children, families, and compliance. This position is responsible for accurately billing and collecting on Medicaid claims, working denials, and reporting denial trends in internal stakeholders.

• Medical, dental, vision, and supplemental insurance options, including HSA match for qualifying contributions.
• Parental Paid Leave
• Retirement savings plan with company match.
• Paid time off and holiday pay.
• Mileage reimbursement.
• Tuition reimbursement available.
• Company sponsored learning and development

Other duties may be assigned as necessary.

• Confirming patient insurance eligibility, correctly assigning medical codes (CPT/ICD-10), and preparing and submitting claims to third-party payers.
• Communicate with internal stakeholders to address billing questions and concerns.
• Review and submit insurance claims accurately, ensuring compliance with payer requirements and coding standards.
• Track and follow up on unpaid claims, working with payers to resolve denials and rejections within deadlines.
• Prepare and submit letters of appeal for denied claims, ensuring that all required documentation is included.
• Monitoring aging reports, tracking outstanding balances, and minimizing payment delay.
• Maintain up-to-date knowledge of industry regulations, payer policies, and coding changes.
• Ensure compliance with all state and federal regulations, including HIPAA.
• Perform all duties within contract, state and federal regulations, Arrow policy, NCASES and COA standards.
• May be required to drive vehicles, be insurable with our auto insurance provider, and complete company vehicle training.
• Occasional travel may be required.

Bachelor's degree in human services, business, finance, statistics, or related field required, master's degree preferred. The ideal candidate will have child welfare experience with a minimum of five (5) years relevant experience in revenue cycle operations, including billing, coding, reimbursement process, data analysis and risk management.