Revenue Cycle Specialist - Onsite Position - Sandpoint

Key Responsibilities

• Ensure accurate entry of patient demographics, insurance details, and treatment codes (CPT, ICD-10, HCPCS).
• Review patient accounts and clinical documentation to ensure accurate billing.
• Follow up on unpaid or denied claims; investigate and resolve denied or rejected claims, discrepancies or errors.
• Assist in the review of patient refunds and adjustments.
• Respond to patient and insurance inquiries related to billing, payment plans, and account status.
• Maintains current knowledge of insurance guidelines, coding practices (including CPT, ICD-10 and HCPCS codes), and compliance regulations including payer policies and HIPAA regulations.
• Collaborate with providers, coding staff, and front desk to resolve documentation or billing issues, and escalate any discrepancies and complex billing issues to Revenue Cycle Manager.
• Generate and analyze aging reports and accounts receivable reports to support cash flow goals.
• Provide reporting for Quality and VBC as needed.
• Reconcile accounts receivable and identify trends.
• Support month-end reconciliation and reporting as required.

Experience Needed

• A High School Diploma or equivalent required.
• Certified Coding Specialist qualification or equivalent preferred.
• Minimum 2 years of experience in medical billing, coding or revenue cycle operations in a healthcare setting.
• Strong knowledge of medical terminology, insurance processes, insurance plans, billing codes (ICD-10, CPT, HCPCS) and reimbursement methodologies.
• Proficient in using medical billing software and electronic health records (EHR) systems (Athena and/or NextGen).
• Familiarity with Medicare, Medicaid, and commercial payer policies.
• Excellent organizational and time-management skills.
• High attention to detail and accuracy.
• Strong problem-solving and analytical abilities.
• Clear and professional communication with patients and colleagues.

Work Schedule

Full Time
No. of Hours/week - 40
Monday to Thursday

Qualifications

Candidates must be authorized to work in the United States without current or future employer sponsorship. Relocation assistance is not available for this position.