Revenue Cycle Specialist - Clinical Billing

Job Description

Job Description

Revenue Collections Specialist

Location: New York City, NY
Work Arrangement: 5 days onsite initially, with potential for hybrid flexibility long term
Employment Type: Temp-to-Perm

 

Position Overview

Our client, a leading nonprofit organization supporting individuals with intellectual and developmental disabilities (IDD), is seeking a Revenue Collections Specialist to join their team on a temp-to-perm basis.

 

This role will be responsible for core billing and revenue cycle functions, including insurance eligibility, benefit assignments, payment posting, claim denials, appeals, and collections. The ideal candidate will have strong hands-on billing experience and be able to hit the ground running with minimal training on basic billing functions .

The team can provide training on organization-specific processes and the nuances of IDD billing, including Article 16 and APG requirements. Experience in these areas is a strong plus but is not required if the candidate has a solid foundation in general billing and revenue cycle processes.

 

Key Responsibilities

• Determine client eligibility and insurance coverage
• Identify and assign appropriate primary and secondary insurance benefits
• Review and process billing activity accurately and efficiently
• Post cash and electronic payments and ensure payments are applied correctly
• Review, research, and resolve claim denials
• Determine the reason for denied claims and appropriate next steps
• Prepare and pursue billing appeals and follow up on outstanding claims
• Monitor accounts receivable and outstanding balances
• Identify and resolve billing discrepancies and issues
• Apply knowledge of insurance requirements and payer priorities to billing activities
• Work independently to prioritize and resolve revenue cycle issues
• Collaborate with internal teams to ensure accurate and timely billing and collections
• Learn and apply organization-specific billing procedures and systems
• Support additional billing and revenue cycle initiatives as needed

 

Required Qualifications

• 3+ years of hands-on billing, healthcare, human services, insurance, or revenue cycle experience
• Strong understanding of fundamental billing and revenue cycle processes is required
• Experience determining insurance eligibility and benefits
• Experience assigning primary and secondary payers
• Experience posting cash and electronic payments
• Experience researching, managing, and resolving claim denials
• Understanding of billing appeals and collections processes
• Strong attention to detail and ability to manage a high volume of billing activity
• Strong analytical, critical thinking, and problem-solving skills
• Ability to work independently and take ownership of issues through resolution
• Comfortable learning new systems and processes

 

Preferred Qualifications

• Experience working within the IDD or human services space
• Familiarity with Article 16 billing requirements and APG billing
• Knowledge of Article 31 billing
• Experience with revenue cycle management within a nonprofit or healthcare environment

IDD-specific billing knowledge, including Article 16, APG, and Article 31 requirements, can be trained. The priority is finding someone with a strong foundation in general billing who can quickly learn and apply the organization's specific billing processes.

 

Ideal Candidate

The ideal candidate is someone who can hit the ground running with the fundamental billing responsibilities of the role. They should not require extensive training on basic billing functions such as determining eligibility, assigning benefits, posting payments, understanding payer requirements, working denials, or determining how to appeal and resolve denied claims.

 

This person should be a critical thinker, proactive problem solver, and self-starter who can work independently, make sound decisions, and take ownership of their workload.

 

The organization will provide training on its internal systems and the specific nuances of IDD billing. Candidates with prior Article 16, APG, or Article 31 experience will have an advantage but are not required.

 

Pandologic. Keywords: Healthcare Revenue Cycle Representative, Location: MANHATTAN, NY - 10060 , PL: 604314571