Revenue Cycle Specialist

Job Description

Job Description

Description:

The Patient Accounts & Revenue Cycle Specialist is a critical role responsible for managing the entire financial   lifecycle of patient services, from initial charge entry to final payment resolution. Key duties include submitting clean claims to insurance payers, diligently working denials and appeals, posting payments, and collecting patient balances. This position serves as a primary point of contact for patients regarding billing inquiries, requiring a deep understanding of insurance policies, CPT codes, and regulations to ensure the financial health of the practice while providing excellent customer service 

Responsibilities:   

• Responsible for receiving hospital cards from all physicians with hospital privileges, registering patients in the electronic health record, and verifying insurance coverage 
• Responsible for obtaining additional authorizations for add on procedures from hospital cards  
• Responsible for retrieving hospital medical records from portals and uploading to the electronic medical record in-line with standardized workflow. 
• Responsible for calling patients seen in the hospital by an SEC physician and accurately scheduling appropriate follow-up visits as ordered by provider instructions as well as estimating any specialist office visit copays. 
• Provides cross-coverage for Insurance verification team.  
• Timely and accurately completes all assigned T and D jellybeans and actions 
• Maintains strict confidentiality according to HIPPA privacy and security rule 
• Works denied hospital claims and obtain any necessary retro authorizations. 

Education and Qualifications : 

• High school graduate or GED, required 
• Insurance billing and/or coding experience preferred  
• Experience with eClinicalWorks preferred  

Job Skills:   

• Demonstrates the ability to achieve accuracy and consistency - attention to detail when entering in demographic information and confirming insurance  
• Demonstrates excellent verbal and written communication skills  
• Demonstrates proficient computer/electronic medical record system skills 
• Exhibits an ability to adapt to unpredictable situations within the work setting; ability to remain flexible  

Compensation  

Starting Hourly Pay: $18.75 per hour 

Salary based on experience- Starting pay will be determined based on the candidate's relevant skills, qualifications, and experience.