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Revenue Cycle Specialist
Revenue Cycle Specialist
The Revenue Cycle Specialist is primarily responsible for patient revenue management support throughout the revenue cycle, to include but not limited to: Claims Management, Accounts Receivable, Cash Posting and Denials Management.
May be required to do one or all of the following dependent on the RCM needs (including but not limited to):
- Claim Scrubbing/Submission
- Assists with third party billing process through the scrubbing, preparation and submission of accurate and complete claims in a timely manner.
- ERA Processing/Cash Posting
- Preparation and posting of daily cash receipts, Completion of daily transaction logs. Scanning, verifying and posting of remittances. Identification of unposted cash. Printing of posting reports for balancing.
- Accounts Receivable
- Resolve outstanding payer balances for assigned financial class by monitoring Accounts Receivable reports
- Follow-up on outstanding claims and submit appropriate documents for payment when necessary
- Denial Analysis/Management
- Identifies, analyzes, and researches frequent root causes of denials and develops corrective action plans for resolution of denials working directly with the payers and/or clinics. Follow through on claim denials and rejections on timely basis
Skills and Qualifications:
- Possesses the ability to work in a constantly changing environment, good judgment skills, and capable of making decisions with attention to detail.
- Must have excellent organizational skills and ability to prioritize and coordinate workload with high degree of proficiency and accuracy.
- Must have excellent analytical and problem-solving skills.
- Ability to work easily and cooperatively with other departments.
- Ability to work independently and follow through on tasks without direct supervision.
- Ability to work well under pressure in a flexible, diplomatic and expeditious manner.
- Maintains strict confidentiality of patients’ medical records and adherence to all HIPAA policies and regulations.
- Minimum 2 years Revenue Cycle experience in a healthcare setting
- Must have excellent computer knowledge of Patient Accounting systems
- High School Diploma or equivalent required. Associates or Certification(s) a plus.
- Location could vary dependent on need
We are an Equal Opportunity Employer with a commitment to diversity. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, disability or veteran status.