Revenue Cycle Specialist - Healthcare Provider - Mooresville NC Corporate Support Center

Revenue Cycle Specialist

Highlights Healthcare is seeking a passionate and dedicated Revenue Cycle Specialist to join our corporate support team. Our team supports our ABA and Hospice centers throughout the southeast.

The Authorization / Billing Specialist supports the organization's revenue cycle by securing payer authorizations, verifying insurance coverage, maintaining accurate billing and accounts receivable records, and helping prevent denied or delayed claims. The position serves as a liaison among insurance companies, patients or families, physician offices, and internal teams while monitoring account status, identifying inconsistencies, and maintaining clear documentation in billing and electronic medical record systems.

Why you should consider a Revenue Cycle Specialist with Highlights Healthcare:

• Competitive pay, commensurate with experience
• Full-time employment
• Benefits include Paid Time Off (PTO), Health, Dental, and Vision Insurance, Employee Assistance Program (EAP), 401K, Health Savings Account (HSA)
• Supportive/collaborative work environment
• Growing company committed to clinical excellence

Position Overview

The person in this position must be able to perform the following essential job functions with or without reasonable accommodations.

• Authorization Procurement: Initiate, track, and obtain prior authorizations from third-party and government payers by telephone, fax, or online provider portals.
• Clinical Documentation Review: Review medical records, physician orders, and supporting notes to ensure documentation supports payer requirements and medical necessity.
• Insurance Verification: Verify patient insurance eligibility, benefits, coverage limitations, deductibles, and other payer requirements to support accurate authorization and billing.
• Communication & Liaison: Communicate with patients or families regarding authorization status and applicable financial information; coordinate with physician offices and internal teams to obtain required documentation.
• Documentation & Data Entry: Maintain accurate, detailed notes in EHR/EMR and billing systems, including Central Reach where applicable.
• Denial Management: Review denied authorization requests, identify root causes, gather additional documentation, and resubmit or appeal as appropriate.
• Workflow Optimization: Prioritize urgent or time-sensitive requests and work to secure authorizations before scheduled services to reduce delays in care and prevent avoidable denials.
• Billing & Accounts Receivable: Receive and sort incoming payments, manage account status and balances, and identify discrepancies or inconsistencies.
• Billing Transactions: Issue and post bills, receipts, and invoices; review account validity and maintain accurate transaction records.
• Accounts Receivable Maintenance: Update accounts receivable records with new accounts, payments, missed payments, and other relevant activity.

• Reporting: Prepare thorough, accurate reports on authorization, billing, account status, and related activity using clear and reliable data.

Additional Responsibilities:

• Perform general office duties to support Highlights Healthcare daily operations.
• Suggest improvements and changes to processes and policies to improve productivity or customer satisfaction.
• Maintain industry knowledge to keep skills current and to develop professionally.
• Comply with Highlights Healthcare's vision, mission, and values.
• May be required to be available afterhours which includes evenings, weekends, and holidays.

Qualifications / Educational Requirements:

• High school diploma or GED required; college education in Finance, Accounting, Health Information Management, Medical Coding, or a related area is preferred.
• 12 years of experience in medical billing, insurance verification, prior authorization, accounts receivable, or a related healthcare administrative role.
• Familiarity with medical terminology, ICD-10 diagnosis codes, and HCPCS/CPT codes.
• Knowledge of laws, payer requirements, and best practices related to customer, patient, financial, and healthcare data.
• Proficiency in MS Office, especially Excel and Word; experience with EMR/EHR or practice management systems such as Central Reach.
• Comfort working with numbers and processing financial information.
• Strong attention to detail, organization, time management, critical thinking, productivity, written and verbal communication, and customer service.
• Ability to work effectively in a fast-paced, team-oriented environment and manage competing priorities under pressure.
• Results-driven, patient, and able to exercise sound judgment when resolving authorization or billing issues.

The above tasks reflect the essential functions and other job functions considered necessary for the job identified and shall not be construed as a detailed description of all work requirements that may be inherent in the job or assigned by supervisory personnel. This job description is used as a guide only and is not inclusive of all responsibilities and job duties.

Highlights Healthcare, LLC is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or Health insurance.

COVID-19 considerations: HHC follows all applicable CDC guidelines.