Revenue Cycle Specialist

About This Role

Managing the entire revenue cycle process is the core of this vital role, ensuring accurate billing, coding, and claims submission to maximize reimbursement and streamline financial operations. Your expertise will help improve cash flow, reduce denials, and enhance patient satisfaction through efficient claims management and outstanding customer service. This opportunity is perfect for a detail-oriented individual who thrives in a fast-paced environment and possesses a passion for healthcare finance.

Responsibilities

• Review and accurately code medical procedures and diagnoses using CPT (Current Procedural Terminology), ICD-9, ICD-10, and DRG (Diagnosis-Related Group) coding systems to ensure proper billing compliance
• Prepare and submit healthcare claims using billing software and Electronic Medical Records (EMR) or Electronic Health Records (EHR) systems, ensuring timely processing
• Follow up on unpaid or denied claims by investigating issues related to healthcare claims management, medical records, or missing documentation
• Collaborate with insurance companies and patients to resolve billing discrepancies while providing exceptional customer service
• Maintain detailed records of medical coding, billing activities, and collections in accordance with healthcare regulations
• Stay updated on health insurance policies, coding changes, and industry best practices to optimize revenue cycle processes
• Assist in training team members on medical terminology, billing procedures, and software systems to promote continuous improvement

Requirements

• Proven experience in medical billing, medical coding, or revenue cycle management within a healthcare setting
• Strong knowledge of healthcare claims management, health insurance policies, and medical terminology
• Proficiency with Microsoft Office Suite (Word, Excel) as well as billing software and EMR/EHR systems
• Familiarity with DRG, CPT coding, ICD-9/ICD-10 coding standards, and medical records management
• Excellent communication skills with a focus on customer service for patients and insurance providers
• Ability to analyze complex data related to medical billing and collections efficiently
• Knowledge of healthcare regulations related to medical coding and billing practices is highly desirable

Benefits

• 401(k)
• Flexible schedule
• Paid time off

Important Details

• Schedule: 47.0 hours per week