Revenue Cycle Specialist

ONET Systems is a leading out of networking billing company located in New Hyde Park, Long Island. We are a full-service billing company dedicated to maximizing out-of-network receivables for our clients and ensuring the best service based on their individual needs. We are currently seeking Revenue Cycle Specialists with a great work ethic, to manage the revenue cycle process including pre-submission review, claim submission and follow-up. Under the direction of the Billing Manager, this role will be instrumental in ensuring timely claim submission, follow up with payers and handling billing discrepancies. This position requires well-rounded knowledge of the revenue cycle process while maintaining compliance with industry regulations.

Key Responsibilities : Responsibilities include insurance verification, reviewing submitted claims for accuracy and completeness, investigating and resolving claim denials by analyzing documentation and using appropriate CPT and ICD-10 codes. In this role you will work on insurance appeals and corrected claim information and work closely with providers, coders, and administrative staff to ensure accurate documentation and billing. You will provide timely billing and reimbursement for services while maintaining compliance with industry regulations. This position requires the ability to utilize and navigate through all available portals for claim information. You will be responsible for tracking and documenting follow-up activities to ensure completion of work and provide updates regularly. The ideal candidate must be detail-oriented, organized, and capable of navigating the complexities of healthcare billing and insurance systems to optimize revenue flow.

Qualifications and skills required :

• High School diploma or equivalent
• Minimum of 3 years medical billing experience
• Out-of-network billing experience strongly preferred
• Strong communication and interpersonal skills
• Excellent attention to detail and organizational skills
• Must be flexible and adaptable to various work environments
• Must be computer proficient