Revenue Cycle Specialist-Remote

Position Summary: 

Under direct supervision of the Revenue Cycle Supervisor, this position is responsible for assuring timely collection of accounts receivable, monitoring account activity and providing adequate follow up to ensure maximum reimbursement is received for physician billing. The ideal candidate would have a strong understanding of medical claims billing.  

Research and resolve claims denials using the appropriate resources 

Check that pre-bill claims are passing internal edits in a timely fashion  

Monitor that all denied claims are corrected or appealed  

Collaborate with other teams within the business office  

Provide appropriate feedback to management. 

Qualifications: 

High School Diploma or general education degree (GED)  

2 – 4 years of physician office billing and denial management experience required 

Basic Understanding of ICD10, CPT HCPCS  

Ability to read and interpret explanation of benefits (EOBs) 

Knowledge of Medical Assistance, Medicare Part B and commercial insurance products  

Familiar with CMS 1500 

Basic understanding of medical terminology and anatomy.   

Athena experience strongly preferred 

Excellent communication skills both written and verbal 

Must be a self-starter that is detail oriented and capable of multi-tasking 

Requires comprehensive knowledge of computer skills including Microsoft Office Suite 

Comfortable in a fast-paced working environment of a growing practice 

Key Responsibilities: 

Performing collection activities, such as status calls to ensure timely reimbursement, appeals and account review. 

Ensuring appropriate information is submitted to insurance companies in order to expedite payment. 

Take appropriate follow up actions on accounts to ensure claims are paid on the first follow-up call or appeal. 

Determine that appropriate information is submitted to insurance companies in order to expedite payment. 

Following up on assigned cases from within the organization 

Reviewing pre-bill claim holds to verify that the claim goes out clean the first time 

Composing appeals to insurance carriers for denied claims 

Handle incoming calls for information request from insurance companies within 24 hours. 

Assisting Financial Counselors when patients have questions regarding claims 

Corrects accounts that are billed to incorrect insurance companies. 

Ensures authorizations are attached to claims 

Comply with quantity and quality expectations as provided by management 

Communicating with the lead, supervisor and team to advise of trends, issues discovered 

All other duties as assigned