Revenue Cycle Specialist

About the Company

CardioOne partners with independent cardiologists to provide innovative solutions that improve patient outcomes and reduce costs. Our platform helps our physician partners thrive in today’s fee-for-service environment and prepare for success in value-based care. In February 2024, we partnered with WindRose Health Investors as well as top physician services and payor executives to grow our team and invest in our next phase of growth.

Join us in our mission to positively impact US cardiology.

About the Job

We are seeking a detail-oriented and seasoned Revenue Cycle Specialist to join our growing team! The ideal candidate will have a demonstrated knowledge of medical billing, preferably in cardiology services. We seek an organized critical thinker with billing knowledge and who is comfortable working with providers, insurance companies, and in a fast-paced environment. This role offers an exciting opportunity to dive into the heart of healthcare finance, where you'll play a crucial part in our practice's success while developing valuable skills for your future career growth.

What you’ll do:

• Ensure that insurance information is entered correctly for successful claim submission and payment.
• Communicate with patients to ensure understanding of patient balance, billing concerns, projected out of pocket expenses, and correct insurance information is on file.
• Work in multiple computer systems to obtain and organize information to support billing.
• Resolve claims that require pre-bill resolution.
• Resolve payment denials.
• Oversee billing-related inventories in multiple systems, ensuring inventory volume and aging remains within thresholds.
• Conduct reconciliation processes, ensuring no charge goes uncaptured.
• Manage communications between practice and vendor staff and organizations.
• Report status of various revenue cycle metrics and escalates issues for resolution.
• Assist in preparation of reports to share with payers when discrepancies are uncovered.

What you’ll need:

• High school diploma or GED preferred.
• 3+ years experience in the industry required.
• Cardiology or diagnostic imaging experience preferred, including prior authorization requirements/processes.
• Certified Professional Coder preferred.
• Strong understanding of insurance products and claim processing.
• Knowledge of claim formatting and transmission guidelines.
• Detailed understanding of EOB/ERA data and impact on financial responsibility.
• A passion and proficiency for patient advocacy.
• Knowledge of ICD-10 and CPT codes, and modifiers.
• Experience with medical office procedures and medical collections.
• Comfort with electronic medical records systems (Athena Collector knowledge is preferred, Hybrid Chart familiarity is the cherry on top).
• Strong attention to detail and accuracy in data entry.
• Intermediate knowledge of Microsoft Word and Excel.
• Excellent communication skills, both written and verbal, to interact with patients, insurance companies, and healthcare providers.

Work Location

Remote: Colorado (Denver preferred), Delaware, Florida, New Hampshire, New Jersey, Pennsylvania, Texas.

Additional Information

Full-time base hourly rate of $20.00 to $24.00 per hour plus medical, dental, and vision. Pay is negotiable depending on certifications.