
Revenue Cycle Management Specialist
5 days ago
We are seeking a highly skilled Revenue Cycle Management Specialist to join our team. This role is responsible for ensuring the smooth operation of revenue cycle processes, from initial patient registration to final payment.
- This includes reviewing and verifying patient demographic and insurance details prior to claim submission, and accurately processing patient payments, adjustments, and refunds within the billing system.
- The successful candidate will be required to stay abreast of evolving billing guidelines, reimbursement protocols, and regulatory mandates within the medical billing domain.
- They will also be responsible for analyzing and interpreting insurance Explanation of Benefits (EOBs), promptly identifying and rectifying payment disparities for optimal reimbursement.
The following key responsibilities are associated with this role:
- Collaborate effectively with interdisciplinary healthcare professionals, including physicians, nurses, and administrative staff, to resolve billing and coding complexities.
- Actively engage in team meetings and educational sessions to remain informed of emerging trends and regulatory updates in medical billing and coding practices.
- Uphold strict patient confidentiality standards and ensure compliance with HIPAA regulations in all aspects of handling patient information.
- Develop and implement effective processes to improve revenue cycle performance, including claim submission, payment posting, follow-ups, eligibility checks, and denial management.
To be considered for this role, you should possess the following skills and qualifications:
- Demonstrated experience of 2 years in revenue cycle management, encompassing claim submission, payment posting, follow-ups, eligibility checks, and denial management.
- Proficiency with electronic health record (EHR) systems and billing software such as ECW, Karea, Office Ally, Waystar, ModMed, Trizetto, Revolutionehr, Therapynotes, Greenway, and Change Healthcare, among others.
- Competence in utilizing Microsoft Office applications for generating billing financial reports.
- Familiarity with various medical specialties including Internal Medicine, Urology, Ophthalmology, Behavioral Health, Skilled Nursing Home, Home Health Care, and Hospice.
- Strong analytical aptitude and keen attention to detail, enabling the identification and resolution of billing discrepancies.
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