Revenue Cycle Specialist

Description

Looking for a Rewarding Career in Health Care?

AuthoraCare Collective is currently seeking an Revenue Cycle Specialist (Medical Practice, Part B billing and eClinical Works experience).


This is a Full-time remote position Monday - Friday, 8:00am - 5:00pm. *Note: T o be considered for this position, you must reside within the following states: North Carolina, South Carolina, Virginia or Florida*.

Job Summary :

The Revenue Cycle Specialist is responsible for managing and resolving outstanding accounts receivable for the AuthoraCare HouseCalls service line utilizing the Athena platform. This role partners closely with Athena's dedicated revenue cycle support team while maintaining internal ownership of AR follow-up, hold buckets, denial resolution, payment reconciliation support, and revenue integrity workflows.

The Revenue Cycle Specialist serves as the internal operational lead for account resolution activities and ensures timely reimbursement, accurate claim adjudication, and appropriate escalation of unresolved billing issues impacting cash flow.

Our team members enjoy the following benefits: Paid time off (PTO), Seven paid holidays, flexible work schedules, medical, dental, vision, disability, and life insurance. Employee engagement activities and 403B match after 12 months of service.

Requirements

Education and Experience :

• High school diploma or equivalent required. Associate degree in healthcare administration, business, or related field preferred.

• Minimum of 2 years of healthcare accounts receivable or medical billing experience required.


• Experience with medical practice, physician billing and home-based primary care preferred.

• Experience working within eClinical Works required.

• Must have knowledge of Microsoft Office and be able to use Excel and Word efficiently.


• Certification in coding ICD-10 preferred.

• Part B Billing experienced preferred.


Other: Valid state-issued driver's license required. Must carry automobile liability insurance at limits required by agency. Must have own transportation.

Key Responsibilities

• Manage assigned hold buckets and resolve claims on hold due to billing, coding, documentation, eligibility, authorization, and payer-related discrepancies.


• Confirm insurance eligibility, coverage limitations, and obtain necessary prior authorizations to prevent future claim denials.

• Resolve Unpostables payments and upload missing remittances.

• Accurately enter and maintain patient demographics and insurance details into the billing system when needed.


• Address patient inquiries, set up payment plans, and follow up on outstanding self-pay balances while providing excellent customer service.

• Prepare and submit corrected claims, reconsiderations, and appeals within payer deadlines.

• Collaborate and communicate effectively with payers, patients, providers, and internal departments to resolve claim and account issues.


• Maintain accurate and timely documentation of all account activity and payer communications in the EMR.


• Maintain payer enrollments and ensure accurate system setup.


• Monitor AR aging, prioritize accounts based on timely filing limits and performance goals, and support month-end reconciliation activities.


• Escalate unresolved accounts and system-related issues as appropriate and provide updates on high-dollar accounts and recurring payer trends.


• Participate in routine AR review meetings and support reporting activities.


• Ensure compliance with payer guidelines, organizational policies, and HIPAA regulations.