Revenue Cycle Specialist

Job Description

Job Description

About GlyCare

GlyCare is an independent, physician-led provider group that delivers specialized inpatient services within hospital settings. We function as a consultative diabetes management service, partnering with hospitals across multiple states to improve clinical outcomes and operational efficiency. Our team of Nurse Practitioners and Physician Assistants provides high-quality, evidence-based care, supported by a dedicated billing operations team that ensures accurate, timely, and compliant revenue cycle performance.

As we continue to expand rapidly across new markets, we are seeking a detail-oriented and accountable Revenue Cycle Specialist who can operate both independently and collaboratively in a fast-paced, high-volume environment.

We regularly use Excel in this role. To ensure a good fit, candidates will be asked to complete a short, practical Excel exercise during the interview process.

Position Summary

The Charges Specialist is responsible for the accurate and timely capture, review, and submission of professional charges for inpatient services. This role is not data entry. It involves validating, reconciling, and scrubbing billing data received from multiple sources to ensure completeness, accuracy, and compliance prior to submission for reimbursement.

This position owns the end-to-end charge workflow , including census reconciliation, charge validation, and coordination with internal teams to resolve discrepancies. The ideal candidate is highly organized, proactive, and capable of managing charge integrity across multiple facilities and states.

The role requires attention to detail and critical thinking

Key Responsibilities

Charge Capture & Reconciliation

· Perform daily census-to-charge reconciliation to ensure all billable patient encounters are captured

• Identify and resolve missing, duplicate, or incomplete charges across multiple systems
• Ensure accurate linkage between encounter, provider, and charge data
• Reconcile data across EMR, charge files, and billing systems to ensure completeness and consistency
• Maintain detailed reconciliation logs across multiple hospitals and providers

Charge Review, Coding & Validation

• Review charges for accuracy, completeness, and compliance prior to submission
• Validate CPT/HCPCS coding, ICD-10 diagnosis alignment, and appropriate modifier usage
• Verify the accuracy of key billing elements, including place of service (POS), dates of service, authorization requirements, patient eligibility, and correct provider attribution
• Identify and correct invalid, outdated, or non-compliant coding prior to claim submission

Workflow Management

• Process and release charges within defined timeliness standards to support clean claim submission
• Manage high-volume workflows across multiple facilities and states while maintaining accuracy

Analysis, Issue Resolution & Continuous Improvement

• Investigate and resolve charge discrepancies in collaboration with providers, billing, and AR teams
• Analyze trends in charge errors, denials, or delays by provider, service line, or facility
• Identify root causes and partner with clinical and operational leadership to implement corrective actions
• Proactively flag workflow gaps, documentation issues, or system inconsistencies impacting revenue integrity

Collaboration & Communication

• Communicate clearly with providers regarding, coding, and charge-related questions
• Support patient-facing billing inquiries as needed

Operational Support & Scaling

• Support onboarding of new facilities and providers, including validation of charge workflows and coding accuracy
• Maintain organized documentation, tracking tools, and audit-ready records
• Identify and implement process improvements to enhance efficiency, accuracy, and scalability

Qualifications

• 2+ years of experience in medical billing, charge entry, or revenue cycle operations (hospital-based experience preferred)
• Strong understanding of CPT coding and charge workflows
• Experience with charge reconciliation, claim validation, or pre-bill review processes preferred
• Proficiency in Excel, including the ability to analyze, reconcile, and validate large datasets (assessment required as part of the interview process)
• Experience with multi-state or multi-facility billing environments strongly preferred
• Familiarity with EMR and billing systems (Cerner, Epic, PracticeSuite)
• High attention to detail with the ability to identify discrepancies, investigate root causes, and resolve issues independently
• Strong organizational and time management skills, with the ability to manage high-volume workflows and meet deadlines
• Effective communication skills, with the ability to collaborate with clinical and billing teams

Core Competencies

• Accountability: Takes ownership of charge accuracy and reconciliation outcomes
• Organization: Able to track and manage multiple workflows simultaneously
• Proactivity: Identifies issues early and drives resolution without waiting for direction
• Collaboration: Works effectively across teams while maintaining individual productivity
• Adaptability: Thrives in a high-growth, evolving operational environment

Why Join GlyCare?

• Be part of a rapidly expanding, multi-state healthcare organization focused on transforming inpatient diabetes care
• Play a critical role in revenue integrity, directly impacting operational performance and financial outcomes
• Work in a highly collaborative, fast-paced environment with opportunities to grow alongside the organization

This position will be in office Monday - Friday

Compensation:

Salary Range: $52,000- $58,000 annually (commensurate with experience)

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