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.