Billing & Revenue Cycle Specialist - Occupational Health

The Billing & Revenue Cycle Specialist provides revenue cycle and administrative support for Occupational and Employee Health services, including billing, accounts receivable follow-up, denial resolution, cash handling, employer account maintenance, documentation management, and coordination of daily operational support activities. This role collaborates with clinical staff, employers, payers, and internal departments to support timely reimbursement, regulatory compliance, and efficient clinic operations.

• High School diploma or equivalent required.
• Associate’s degree preferred.
• Certified Revenue Cycle Specialist (CRCS) required.
• Minimum two (2) years’ experience in medical billing, credit and collections required.

• Knowledge of revenue cycle processes, including billing, accounts receivable, and denial resolution.
• Familiarity with electronic claims submission, remittance processing (ERA), and electronic funds transfer (EFT).
• Strong analytical and problem-solving skills with the ability to resolve claim discrepancies.
• High level of accuracy and attention to detail in data entry and financial reconciliation.
• Ability to prioritize and manage multiple tasks in a fast-paced clinical environment.
• Proficiency in Microsoft Office applications, including Word and Excel.
• Ability to learn and effectively utilize SYSTOC EMR and related software systems.
• Strong organizational skills with the ability to maintain confidential records.
• Effective interpersonal and customer service skills.
• Strong written and verbal communication skills.
• Strong initiative with ability to independently prioritize and manage workload
• Adaptability and initiative in managing workload and responding to change.

• Process daily, monthly, and ad hoc billing for Occupational Health and Employee Health services, including insurance, workers’ compensation, and direct-to-employer accounts.
• Perform charge entry, payment posting, daily deposits, and accounts payable/accounts receivable functions within SYSTOC and in coordination with the Augusta Health centralized billing department.
• Oversee assigned accounts receivable to ensure claims are processed to completion and reimbursement is optimized.
• Identify and resolve invalid, incomplete, or missing claim data prior to and following claim submission.
• Research and resolve denied claims, including preparation and submission of appeals; correct claim data and rebill as appropriate.
• Maintain working knowledge of payer standard transaction sets, including electronic claim submission, electronic remittance advice (ERA), code sets, and electronic funds transfer (EFT) processes to ensure timely payment and account resolution.
• Support the acquisition and verification of required referrals, authorizations, workers’ compensation data, and claim numbers necessary for treatment coordination and claim submission.
• Respond promptly to payer, employer, and patient correspondence regarding billing and claims.

• Coordinate daily cash flow processes, including balancing cash drawers and reconciling daily deposits.
• Monitor deferred revenue records and related tracking spreadsheets.
• Maintain accurate and organized departmental billing files.
• Prepare and distribute daily and monthly billing and revenue reports to department leadership.

• Accurately enter and maintain employer account information and data, new company set‑ups, and company‑specific requirements within SYSTOC and the OH/EH database.
• Record and coordinate medical records requests within SYSTOC in accordance with department procedures.
• Main…