Healthcare Revenue Cycle E&A Specialist

4 weeks ago

Saddar Town, Pakistan SimiTree Healthcare Consulting Full time

About the SimiTree:
SimiTree offers a robust suite of outsourced services, consulting, and technology to the Home Health, Home Care, Hospice, and Behavioral Health industries. Our Post-Acute Revenue Cycle Management team helps post-acute care providers grow stronger and healthier by optimizing operations, revenue, and clinical performance. SimiTree brings industry expertise and a wide range of proven solutions together to guide organizations through challenges, changes, and growth.

About the Role:
The Revenue Cycle E&A Specialist plays a critical role in supporting efficient and compliant revenue cycle operations. This position is responsible for ensuring accurate and timely insurance verification, managing authorizations, and tracking physician orders. The ideal candidate will have strong attention to detail and the ability to manage multiple administrative tasks across various systems. This role also involves maintaining internal records, verifying patient benefits, securing insurance authorizations, and contributing to team training efforts.

Position:Revenue Cycle E&A Specialist
  • Location: Remote
  • Applicants: Only international applicants (outside the United States) will be considered
  • Shift Timing: 9:00 AM to 5:30 PM (Eastern Time)
  • Salary Range: Competitive (Based on Experience & Interview Performance)
  • Working Days: Monday to Friday
What We're Looking For:
  • Education: Master's degree or equivalent from an HEC-recognized and well-reputed university
  • Field of Study: Accounting, Finance, Healthcare Administration, or a related field
  • Experience: Current, hands-on experience in an Accounts Receivable role
  • Current Employment: Must currently be working with a well-reputed Revenue Cycle Management (RCM) company
  • Expertise: In-depth understanding of medical billing rules, insurance guidelines, and regulatory compliance
  • Language: Exceptional fluency in spoken English, with outstanding written and verbal communication skills
Key Responsibilities: The Revenue Cycle E&A Specialist will be responsible for managing a variety of administrative and operational tasks critical to the revenue cycle process, including:

Insurance Verification
  • Perform initial verification of patients' insurance coverage for services
  • Conduct monthly re-verifications to identify any changes in insurance
  • Accurately document verification information within the client's Electronic Medical Record (EMR) system
Authorization Management
  • Submit initial authorization requests to insurance companies for services requiring pre-certification
  • Compile and submit required medical documentation from the client's EMR to support authorization requests
  • Manage follow-up and subsequent authorization requests as needed
Physician Order Tracking
  • Send unsigned physician orders to appropriate physician offices for review and signature
  • Follow up on outstanding or aged unsigned orders and implement strategies for timely completion
  • Review and upload signed physician orders into the client's EMR, ensuring compliance
Documentation & Reporting
  • Develop and maintain internal tracking spreadsheets and databases to support day-to-day workflow
Team Support
  • Assist in training new or existing staff on workflows and best practices
  • Support other administrative or operational duties as assigned
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