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Revenue Cycle Operations Specialist

Revenue Cycle Operations Specialist

AllCare Georgia - AllAtlanta, GA, US
22 hours ago
Job type
  • Full-time
Job description

Job Description

Job Description

Description :

Are you a detail-oriented professional with a passion for healthcare operations and revenue cycle management? Join our team as a Revenue Cycle Operations Specialist and play a key role in streamlining processes, improving claim accuracy, and supporting patient and provider communications.

Credentialing & Enrollment

  • Manage Medicare and Piedmont provider credentialing and location updates.
  • Research and facilitate enrollment for miscellaneous insurances.
  • Maintain CAQH profiles and update provider credentials in Athena.

Coding & Documentation

  • Collaborate with Omega weekly to resolve coding queries.
  • Audit coding accuracy and research payer requirements.
  • Review provider documentation and modifier holds for timely filing.

    • Claims & Holds

  • Process an average of 50 holds daily, including coding and credentialing.
  • Review Explanation of Benefits (EOBs) and adjust patient balances.
  • Create claims for self-pay and late cancellation / no-show fees.

    • Patient Communication

  • Respond to patient emails and biller inbox inquiries.
  • Escalate billing complaints and provide weekly collection call lists.

    • Reporting & A / R

  • Prepare weekly revenue cycle and goal update reports.
  • Review outstanding A / R and follow up with insurance and patients.
  • Conduct payment research and process refunds.

    • Special Projects

  • Maintain fee schedules, allowed amounts, and Athena cases.
  • Monitor payment mismatches and communicate with Mindoula on denied claims.

    • Meetings & Collaboration

  • Participate in weekly and monthly meetings with internal and external teams.
  • Support cancellation tracker reviews and insurance accuracy audits.

    • Requirements : What You Bring

  • Bachelor’s degree in Finance, Healthcare Administration, or equivalent experience.
  • 5–7 years of experience in healthcare revenue cycle management.
  • Athena experience required ; CAQH familiarity preferred.
  • ICD-10 Certification.
  • Strong knowledge of billing, coding, and compliance.
  • Excellent analytical, organizational, and communication skills.
  • Sign on bonus at the end of 90 days dependent on knowledge
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