Revenue Cycle Specialist, Primary Care

Position Summary

Coastal Horizons Center, Inc. has an opportunity for a Revenue Cycle Specialist to join our Revenue Cycle Department. The Revenue Cycle Specialist is responsible for all facets of medical billing and accounts receivable management including charge entry, coding, and follow-up in accordance with practice protocol with an emphasis on maximizing patient satisfaction and profitability specific to our Primary Care department.

Primary Duties/Responsibilities

• Review clinical documentation for accuracy and ensure proper coding prior to processing electronic claims.
• Communicate and educate providers and/or managers when coding errors are identified and/or when payer requirements change as it relates to coding.
• Collaborates with Billing Manager and AR Manager to identify insurance denial trends and other issues resulting in non-payment and discuss how to reduce denials
• Collaborate with Manager to build and/or update the billing/coding and resource manuals specific to Primary Care services.
• Collaborate with the Patient Access Specialist to reconcile client accounts with eligibility related issues.

Required Educational/Experiential Qualifications

• Associates or Bachelors Degree with and/or 2-3 years’ experience related to responsibilities specified in a Primary Care setting
• CPC certification required
• Knowledge of billing concepts, practices, and procedures specific to Primary Care
• Experience with health care billing systems (preferably Welligent experience).
• Experience with reviewing clinical documentation to apply CPT and ICD-10 codes for billing purposes
• Strong understanding of Revenue Cycle
• Basic computer skills including Office 365, Teams, and Excel

Salary & Benefits

• Competitive salary based on experience
• Comprehensive medical, dental, and vision insurance
• Education loan repayment programs & Career growth
• Retail savings plan/401K
• Paid time off programs, rollover hours, 14 paid holidays
• Employee engagement activities, resource groups, and diversity events