Revenue Cycle Specialist II

Revenue Cycle Specialist II

The Revenue Cycle Specialist II will be responsible for a variety of claims management functions including but not limited to reading Patient Care Reports and Certificate of Medical Necessities to determine appropriate ICD-10 codes to be assigned as well as HCPCS Codes and Modifiers on Ambulance Transport Claims, to ensure clean submission and resolution of said claims. The RCS-II reports directly to the Accounts Receivable Manager and would be eligible for a hybrid remote work schedule at the completion of six months of successful employment.

Role and Responsibilities

• Coding of Ambulance Claims (ICD-10, HCPCS, & Modifiers).
• Prepare and submit claims to Medicare, Medicaid, private insurance, and self-pay patients.
• Apply accurate modifiers (e.g., origin/destination, transport type).
• Ensure proper use of ABNs (Advance Beneficiary Notices) when required.
• Enter charges into billing systems accurately and timely.
• Submit secondary and tertiary claims when applicable.
• Return of Claims to Crews or Facilities for Corrections.
• Manage inbound customer calls.
• Verification tasks specific to payor type.
• Researches all information to complete accurate billing processes including assignment of billing charge codes and ICD-10 diagnosis codes.
• Maintain productivity and accuracy standards.
• Adhere to all HIPAA regulations and compliance guidelines.
• Demonstrate a strong commitment to workplace safety by identifying hazards, reporting risks, and supporting continuous safety improvements.
• Adhere to all company safety policies, procedures, and regulatory requirements while actively promoting a safe and compliant work environment.
• Collaborate with team members to uphold safety standards and foster a culture of safety across all operations.
• Other duties as assigned.

Qualifications and Education Requirements

• Must be at least 18 years old or older at time of hire
• Graduation From High School or equivalent
• Customer service experience
• Ability to view computer monitor for extended periods (more than 8 hours)
• Ability to remain composed and multi-task in a busy, high-pressure environment.
• Ability to comprehend or learn department practices, rules, and regulations quickly.
• Ability to operate telephone and other specialized computer communication equipment.
• Ability to learn new software.
• Ability to speak clearly, concisely, and respectfully.
• Ability to communicate effectively with a diverse population, including medical professionals.
• Ability to think and react quickly and effectively in tense situations.
• Ability to follow written and oral instructions.
• Ability to recall details from numerous informational resources.
• Ability to prioritize decisions based upon multiple criteria and identifiable standards of policies and procedures.
• Maintain a reliable attendance record and be punctual daily.
• Pass background investigation
• Pass a pre-employment drug screen and all subsequent random or for cause drug screenings.
• Ability to lift up to 25 lbs.
• Ability to speak, read, and write English

Preferred Skills

• ICD-10 Coding and billing.
• Knowledge of payor types Medicare, Medicaid, private insurance
• Proficiency in Microsoft Office Suite

We'd love to have you join the WLRC Medical Team!