Revenue Cycle Representative II (Full Time)

A day in the life

• Follow up on denied, underpaid, and pending claims through payer websites, phone calls, and internal systems.
• Investigate and resolve claim denials by submitting corrected claims, reconsiderations, appeals, and supporting documentation.
• Review complex claim issues and analyze medical records, payer guidelines, charges, and diagnoses to support accurate reimbursement.
• Submit medical records and additional documentation to payers as needed for claim adjudication.
• Manage multiple work queues, payer plans, and denial types while meeting productivity and quality standards.
• Monitor payer and industry updates and communicate relevant changes to the team.
• Ensure compliance with coding guidelines, payer requirements, and patient confidentiality standards.
• Collaborate with team members and leadership to support operational goals, workflow efficiency, and denial resolution efforts.
• Assist with overall denial management workload and contribute to a positive, professional work environment.

Qualifications

• Minimum 2 years of experience working in a medical office or billing environment with medical billing, denials and insurance collections required.
• Previous experience working in a medical office and a working knowledge of revenue cycle and payer denial practices.
• Awareness of medical terminology required.

Bonus points if

• CPC certification preferred.
• Exposure to different types of insurance programs preferred.