Remote Revenue Cycle Specialist - Unbilled

About the role

The Revenue Cycle Specialist - Unbilled supports various aspects of the revenue cycle process, including claims submission, billing, coding, payment posting, and accounts receivable management. This position ensures timely and accurate reimbursement by identifying and resolving claim issues, following up with payers, and adhering to payer and regulatory guidelines.

Responsibilities

• Reviews and submits claims to payers, ensuring accuracy and adherence to payer and regulatory guidelines.
• Identifies and resolves claim denials and rejections by researching root causes, correcting errors, and resubmitting claims as needed.
• Affords assistance with payment posting and reconciliation to ensure accuracy and resolve payment discrepancies.
• Performs follow-up on outstanding accounts receivable (AR) balances, working with payers to expedite payments and resolve issues.
• Reviews coding and billing for accuracy, collaborating with team members to address discrepancies and ensure proper use of CPT, ICD-10, and HCPCS codes.
• Maintains awareness of payer requirements and updates processes to ensure compliance with changes in policies and regulations.
• Maintains accurate documentation of revenue cycle activities, including claim follow-up, denial resolution, and payment posting.

Qualifications

• H.S. Diploma or GED required.
• Associate Degree in Healthcare Administration, Business, or a related field preferred.
• 1-3 years of experience in healthcare revenue cycle operations, including claims processing or accounts receivable management required.
• Experience with claim denials and payer reimbursement processes preferred.
• Familiarity with electronic health record (EHR) systems and revenue cycle software preferred.

Knowledge, Skills And Abilities

• Knowledge of revenue cycle processes, including claims submission, payment posting, and AR management.
• Basic understanding of healthcare billing and coding, including CPT, ICD-10, and HCPCS codes.
• Attention to detail and problem-solving skills for resolving claim and payment issues.
• Organizational skills to manage tasks, prioritize workload, and meet deadlines.
• Strong verbal and written communication skills for collaborating with team members and payers.
• Knowledge of HIPAA and other regulatory requirements impacting the revenue cycle.
• Proficiency with revenue cycle software, EHR systems, and Microsoft Office applications.