Revenue Cycle Support Specialist

Job Description

Job Description

Description:

Job Type: Full-time

Job Classification:

This is a non-exempt position under the Fair Labor Standards Act (FLSA) and is eligible for overtime pay for hours worked over 40 in a workweek, in accordance with applicable federal, state, and local laws.

Our Mission:

Our mission is to drive financial wellness in healthcare organizations so more patients can receive the care they need. 

Our Vision:

Our vision is a future where we help healthcare organizations thrive in a complex ecosystem by clearing a path to financial health. 

Our Culture:

We are committed to creating a workplace where every member feels valued, empowered, and inspired to contribute their best. Together we will foster a culture that promotes work-life balance and celebrates community engagement, personal achievements, milestones, and special occasions. 

Values:

• Integrity – We do what’s right, no matter what. 
• Innovation – We use a harmonious blend of data, tech, and a human-centric approach. 
• Compassion – We understand the stress of healthcare organizations and their patients.
• Determination – Our mission is our guiding force. 
• Partnership – We build enduring relationships through listening, communication and accountability. 
• Dignity – We have significant pride in each other and our work. 

Job Summary: The Revenue Cycle Support Specialist will demonstrate behavior that supports PC3 Revenue Cycle’s mission, culture, and values. This is an entry-level position designed for individuals who are interested in developing a career in healthcare revenue cycle management. No prior healthcare or revenue cycle experience is required.

Under the direction and guidance of the Associate Director of Revenue Strategy and Lead Revenue Cycle Specialist as well as other experienced revenue cycle team members, the Revenue Cycle Support Specialist will provide support across various revenue cycle functions. The position will assist with account research, claim review, documentation, insurance follow-up, data collection, and other activities that support the accurate and timely reimbursement of services provided by PC3’s healthcare clients.

The successful candidate will learn how insurance coverage, medical billing, coding, payer requirements, claims processing, and reimbursement processes impact the financial performance of a healthcare organization. Through structured training and hands-on experience, the Revenue Cycle Support Specialist will develop the knowledge and skills necessary to progress into more advanced revenue cycle responsibilities.

This position requires strong attention to detail, organization, dependability, professionalism, and a willingness to learn. The ability to work effectively with team members, follow established processes, protect confidential patient information, and meet established quality and productivity standards is essential.

The Revenue Cycle Support Specialist will receive training in applicable revenue cycle processes, healthcare terminology, payer requirements, medical coding concepts, claim processing, denial management, and the use of electronic medical record and billing systems.

This position reports directly to the Associate Director of Revenue Cycle. 

Supervisory Responsibilities: None

Duties/Responsibilities:

• Provide administrative and operational support to the revenue cycle team across assigned client accounts and revenue cycle functions.
• Assist with reviewing patient accounts and claims for completeness, accuracy, and potential issues that may impact reimbursement.
• Assist experienced revenue cycle staff with researching claim denials, rejections, payment discrepancies, and other account issues.
• Review insurance and claim information and identify missing, incomplete, or potentially inaccurate information for follow-up by appropriate team members.
• Assist with gathering and organizing documentation needed for claim follow-up, appeals, audits, and other revenue cycle activities.
• Perform basic account research using electronic medical records, billing systems, payer websites, and other approved resources.
• Assist with insurance follow-up activities and document account activity accurately and timely in accordance with PC3 and client requirements.
• Learn and apply basic concepts related to CPT, ICD, DRG, HCPCS, revenue codes, claim forms, and payer requirements as part of ongoing training.
• Assist in identifying potential billing errors, claim issues, or other circumstances that may result in delayed or lost reimbursement and escalate those issues to the appropriate team member.
• Assist with maintaining accurate documentation of account activity, follow-up actions, and account status.
• Participate in training related to healthcare revenue cycle functions, insurance requirements, medical terminology, coding concepts, payer policies, and client-specific processes.
• Utilize available resources, including payer websites, client systems, training materials, and internal PC3 resources, to research assigned accounts and develop revenue cycle knowledge.
• Meet quality, productivity, accuracy, and timeliness standards established by PC3 and its healthcare clients.
• Communicate professionally and effectively with PC3 team members, clients, insurance representatives, and other healthcare personnel as appropriate to the responsibilities of the position.
• Protect the confidentiality and security of patient information in accordance with HIPAA and all applicable privacy and security requirements.
• Participate in educational opportunities, including webinars, online training, internal education sessions, and other learning opportunities designed to develop revenue cycle knowledge and skills.
• Participate in process reviews and improvement initiatives as assigned.
• Demonstrate a willingness to learn new systems, processes, payer requirements, and revenue cycle functions.
• Perform other duties as assigned.

Requirements:

Knowledge/Skills/Abilities:

• Strong attention to detail and ability to accurately follow established processes.
• Strong organizational skills and ability to prioritize assigned work.
• Basic computer skills and ability to learn new software applications.
• Ability to communicate clearly and professionally, both verbally and in writing.
• Ability to work effectively as part of a team.
• Demonstrated willingness and ability to learn healthcare revenue cycle processes.
• Ability to maintain confidentiality and comply with HIPAA and other applicable privacy requirements.
• Dependable attendance and commitment to meeting established quality and productivity expectations. 

Education and Experience:

• High school diploma or GED certificate required.
• A minimum of 2 years of directly related experience in a healthcare, insurance, customer service, administrative, or office required.
• Hospital/healthcare related experience is preferred.
• Familiarity with medical terminology.
• Familiarity with healthcare insurance or medical billing concepts.
• Experience using Microsoft Office or similar computer applications.
• Experience with an electronic medical record or billing system. 

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.