Revenue Cycle Specialist I

Entry level position responsible for submitting and resolving medical claims of low to moderate complexity. Must remain current with governmental and third party billing, follow-up and appeal requirements for compliant billing and follow-up of both inpatient and outpatient claims for all wholly owned facilities and physician entities including internal and external policy requirements. Responds to requests from management, staff, or physicians in a timely and appropriate manner. Maintains patient and physician confidentiality and professionalism at all times. Follows department policies and procedures to ensure accurate and timely claim resolution. Effectively communicates utilizing telephone, form letters, e-mail, or internal correspondence to resolve patient inquiries and insurance issues. Attends and participates in team meetings. Utilizes worklists to review and analyze account balances in order to collect payment for medical services rendered. Utilizes multiple system applications to review, update patient information as well as research and resolve outstanding AR balance. Assists in the analysis of claims resolution and provides feedback to management for solutions and process improvements. Performs follow up with insurance companies to ensure appropriate payment on claims, resolve denials, correct claims, and appeal claims. Acts as a liaison with internal and external customers providing assistance in claims and receivables resolution in a high volume environment. Contacts patients and guarantors to secure necessary billing information. Documents accounts with clear and concise verbiage in accordance with departmental procedures. Reviews and responds to correspondence and inquiries received. Meets and exceeds team productivity and quality standards. Performs other related duties as assigned. Requirements High School Equivalent / GED (Required) Associate's Degree in a related field (Preferred) Bachelor's Degree in a related field (Preferred) 1+ years of experience in call center, patient registration, scheduling, office, banking, customer service or related medical field using computers. (Required) Experience with medical billing software (Preferred) Detail-oriented and organized, with good analytical and problem solving ability. (Required proficiency) Notable client service, communication, and relationship building skills. (Required proficiency) Ability to function independently and as a team player in a fast-paced environment. (Required proficiency) Must have strong written and verbal communication skills. (Required proficiency) Demonstrated ability to use PCs, Microsoft Office suite (including Word, Excel and Outlook), and general office equipment (i.e. printers, copy machine, FAX machine, etc.). (Required proficiency) Certification in Medical Billing/Coding from a recognized program, will be accepted in lieu of 1 year of work experience. (Required within 1 Year) Medical Billing/Coding certification (Preferred) Core Competencies Demonstrates proficiency in medical claims submission and resolution, ensuring compliance with billing requirements and maintaining patient confidentiality. Strong analytical, communication, and organizational skills are essential for effective problem-solving and client service in a fast-paced environment. Highest-signal resume keywords Medical Billing Software Experience Certification In Medical Billing/Coding 1+ Years Experience In Medical Field Strong Written And Verbal Communication Skills Detail-Oriented And Organized ATS Optimization Keywords Hard Skills Medical Claims Submission Claims Resolution Analytical Skills Problem Solving Patient Registration Scheduling Office Management Microsoft Office Suite Data Entry AR Balance Resolution Soft Skills Client Service Communication Skills Relationship Building Team Player Independence Certifications & Qualifications High School Equivalent / GED Associate's Degree (Preferred) Bachelor's Degree (Preferred) Medical Billing/Coding Certification Industry Keywords Inpatient Claims Outpatient Claims Billing Compliance Insurance Denials Claims Appeals Patient Confidentiality Healthcare Billing Tools & Technologies PCs General Office Equipment Medical Billing Software #J-18808-Ljbffr Jobtailor