Revenue Cycle Specialist

About This Role

This Revenue Cycle Specialist role is responsible for managing the entire revenue cycle process within a healthcare team, from patient registration and medical coding to billing, claims submission, and collections. The position ensures accurate and timely reimbursement for services rendered, contributing directly to the financial health of the organization. It offers an opportunity to utilize medical billing knowledge, coding skills, and healthcare claims management experience in a fast-paced environment.

Responsibilities

• Review and verify patient information during registration to ensure accuracy for billing purposes
• Assign appropriate medical codes such as CPT (Current Procedural Terminology), ICD-9, ICD-10, and DRG (Diagnosis-Related Group) to diagnoses and procedures
• Prepare and submit clean claims using billing software and EMR/EHR systems to insurance companies and third-party payers
• Follow up on unpaid or denied claims through effective medical collection strategies
• Reconcile accounts receivable, monitor aging reports, and escalate issues as needed to optimize cash flow
• Maintain comprehensive medical records and ensure compliance with healthcare regulations and standards
• Communicate professionally with patients, insurance providers, and healthcare teams to resolve billing issues promptly

Requirements

• Strong knowledge of medical terminology, medical coding (CPT, ICD-9/10), DRG classifications, and healthcare claims management
• Proficiency in Microsoft Office applications, billing software, EMR (Electronic Medical Records), and EHR (Electronic Health Records) systems
• Experience with medical billing processes, including claim submission, follow-up, appeals, and collections
• Excellent customer service skills with the ability to communicate complex information clearly and professionally
• Deep understanding of health insurance policies, benefits verification, and medical records management
• Ability to interpret medical documentation accurately for coding purposes
• Familiarity with healthcare compliance standards and regulations related to billing and coding

Benefits

• Dental insurance
• Vision insurance