Revenue Cycle Specialist

About This Role

Managing the entire financial lifecycle of patient services, from initial charge entry to final payment resolution, is the core of this critical role. The Patient Accounts & Revenue Cycle Specialist submits clean claims, works denials and appeals, posts payments, and collects patient balances, serving as a primary point of contact for patient billing inquiries.

Responsibilities

• Receive hospital cards from all physicians with hospital privileges
• Register patients in the electronic health record and verify insurance coverage
• Obtain additional authorizations for add-on procedures from hospital cards
• Retrieve hospital medical records from portals and upload to the electronic medical record in line with standardized workflow
• Call patients seen in the hospital by an SEC physician and accurately schedule appropriate follow-up visits as ordered by provider instructions
• Estimate any specialist office visit copays
• Provide cross-coverage for the Insurance verification team
• Timely and accurately complete all assigned T and D jellybeans and actions
• Maintain strict confidentiality according to HIPAA privacy and security rules
• Work denied hospital claims and obtain any necessary retro authorizations

Requirements

• High school graduate or GED, required
• Insurance billing and/or coding experience preferred
• Experience with eClinical Works preferred
• Demonstrates the ability to achieve accuracy and consistency - attention to detail when entering demographic information and confirming insurance
• Demonstrates excellent verbal and written communication skills
• Demonstrates proficient computer/electronic medical record system skills
• Exhibits an ability to adapt to unpredictable situations within the work setting; ability to remain flexible