Revenue Cycle Specialist-Remote

Position Summary: 

Under direct supervision of the Revenue Cycle Supervisor, this position is responsible for assuring timely collection of accounts receivable, monitoring account activity and providing adequate follow up to ensure maximum reimbursement is received for physician billing. The ideal candidate would have a strong understanding of medical claims billing.  

• Research and resolve claims denials using the appropriate resources 

• Check that pre-bill claims are passing internal edits in a timely fashion  

• Monitor that all denied claims are corrected or appealed  

• Collaborate with other teams within the business office  

• Provide appropriate feedback to management. 

Qualifications: 

• High School Diploma or general education degree (GED)  

• 2 – 4 years of physician office billing and denial management experience required 

• Basic Understanding of ICD10, CPT HCPCS  

• Ability to read and interpret explanation of benefits (EOBs) 

• Knowledge of Medical Assistance, Medicare Part B and commercial insurance products  

• Familiar with CMS 1500 

• Basic understanding of medical terminology and anatomy.   

• Athena experience strongly preferred 

• Excellent communication skills both written and verbal 

• Must be a self-starter that is detail oriented and capable of multi-tasking 

• Requires comprehensive knowledge of computer skills including Microsoft Office Suite 

• Comfortable in a fast-paced working environment of a growing practice 

Key Responsibilities: 

• Performing collection activities, such as status calls to ensure timely reimbursement, appeals and account review. 

• Ensuring appropriate information is submitted to insurance companies in order to expedite payment. 

• Take appropriate follow up actions on accounts to ensure claims are paid on the first follow-up call or appeal. 

• Determine that appropriate information is submitted to insurance companies in order to expedite payment. 

• Following up on assigned cases from within the organization 

• Reviewing pre-bill claim holds to verify that the claim goes out clean the first time 

• Composing appeals to insurance carriers for denied claims 

• Handle incoming calls for information request from insurance companies within 24 hours. 

• Assisting Financial Counselors when patients have questions regarding claims 

• Corrects accounts that are billed to incorrect insurance companies. 

• Ensures authorizations are attached to claims 

• Comply with quantity and quality expectations as provided by management 

• Communicating with the lead, supervisor and team to advise of trends, issues discovered 

• All other duties as assigned