Revenue Cycle Specialist

About the role

The Revenue Cycle Specialist plays a critical role in managing the financial processes related to medical billing within cardiology services. This position ensures accurate insurance processing, resolves billing issues, and supports communication between providers, insurance companies, and patients. The role contributes to the financial health and operational efficiency of the practice, directly impacting patient billing clarity and revenue cycle performance.

Responsibilities

• Enter insurance information accurately to facilitate successful claim submissions and payments.
• Communicate with patients regarding balances, billing concerns, projected out-of-pocket expenses, and insurance information.
• Use multiple computer systems to gather and organize billing information.
• Resolve claims requiring pre-bill interventions.
• Address payment denials.
• Manage billing-related inventories to maintain volume and aging within thresholds.
• Conduct reconciliation processes to ensure all charges are captured.
• Cook up communications between the practice, vendors, and organizations.
• Report on revenue cycle metrics and escalate issues as needed.
• Aid in preparing reports for payers when discrepancies are found.

Requirements

• A high school diploma or GED is preferred.
• Minimum of 3 years industry experience is required.
• Experience in cardiology or diagnostic imaging, including familiarity with prior authorization processes, is preferred.
• A Certified Professional Coder credential is preferred.
• A strong knowledge of insurance products and claim processing is essential.
• An understanding of claim formatting and transmission guidelines is necessary.
• A detailed knowledge of EOB/ERA data and its financial implications is crucial.
• A commitment to patient advocacy is important.
• A familiarity with ICD-10, CPT codes, and modifiers is beneficial.
• Experience with medical office procedures and collections is advantageous.
• Comfort with electronic medical record systems, such as Athena Collector, is preferred, while Hybrid Chart is an advantage.
• A strong attention to detail and data accuracy are required.
• Intermediate skills in Microsoft Word and Excel are expected.
• Effective written and verbal communication skills are necessary.

Pay, Benefits & Perks

Full-time base hourly rate of $20.00 to $24.00 per hour. Pay is negotiable depending on certifications. Benefits & Perks include Medical insurance, Dental insurance, Vision insurance. Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.