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Revenue Cycle Specialist

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Job Description - Revenue Cycle Specialist

REVENUE CYCLE SPECIALIST 


TITLE: Revenue Cycle Specialist
REPORTS: Senior Director of Revenue Cycle
STATUS: Exempt

 

JOB SUMMARY

The Revenue Cycle Specialist is responsible for managing patient billing accounts, ensuring accurate and timely submission of insurance claims, and maintaining compliance with healthcare regulations. This role requires an understanding of medical terminology and insurance processes. The Specialist plays a crucial role in ensuring the billing process is conducted with precision, efficiency, and in accordance with established timelines.


QUALIFICATIONS

  • Knowledge of medical terminology
  • Excellent attention to detail and organizational skills.
  • Strong communication and problem-solving skills.
  • Knowledge of insurance procedures, Medicaid, and private insurers.
  • Ability to work independently and as part of a team in a fast-paced environment.
 

RESPONSIBILITES AND DUTIES


Insurance Verification: Confirm patient insurance details and eligibility for coverage.
Coding: Assign appropriate codes to patient services based on medical records.
Claims Submission: Prepare and submit accurate medical claims to insurance companies and payers.
Documentation: Maintain detailed records of patient accounts, billing activities, and progress in the EMR system.
Compliance: Ensure all billing practices adhere to healthcare regulations (such as HIPAA) and industry standards.
Reporting: Generate and review billing reports, track revenue, and provide updates to management.

Additional Duties: Complete additional tasks or projects as delegated by management.


WORK CONDITIONS


Physical demands
  • May be confined to a limited workspace.
  • Must be able to bend, stoop, squat, kneel and reach freely.
  • Must be able to lift or move a maximum of 25-50 lbs. with assistance.
  • Specific vision abilities required by this job include close vision, color peripheral vision and the ability to adjust focus.
  • Must have acute hearing and olfactory senses.
  • Employees must have good tactile senses and fine manual dexterity with range of motion to all extremities.
Work environment
  • While performing the duties of this job the employee will encounter moderate physical exertion.
  • The noise level in the work environment is usually moderate to severe.
  • There may be numerous distractions that will need to be filtered out.
 

POSITION AVAILABLE

  • Full-time on-site
  • Monday - Friday 8AM-5PM (some flexibility) 
  • Salary Position


BENEFITS

  • Paid Time Off for Full-Time Employees
  • 401K and Student Loan Reimbursement Available for Full-Time and PRN Employees
  • Health Benefits or HRA
  • Vision and Dental Benefits 
  • Life Insurance (Basic and Voluntary)
  • Long-Term Care with Death Benefit
  • Dependent Care FSA 
  • Short- and Long-Term Disability Insurance packages available for Full-Time Employees
  • Evelyn Mae Williamson Continuing Education Scholarship 


 
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