Senior Revenue Cycle Specialist

Job Summary

The Senior Revenue Cycle Specialist will oversee key aspects of claims processing, including claim submissions, denials management, and insurance verification. This role requires exceptional attention to detail, cross-functional collaboration, and a proactive approach to claims processing.

Skills Required

• Strong knowledge and experience with medical billing and claims processing
• Experience with athenahealth EHR
• Experience with Salesforce preferred
• High attention to detail and strong organizational skills
• Proficient in using data and reports to inform work and optimize revenue cycle performance
• Excellent written and verbal communication skills
• Ability to work independently while also collaborating with multiple departments
• Strong multitasking abilities in a dynamic, fast-paced environment
• Experience with alternative payment models and non-traditional claims submission

Key Behaviors

• Claims Processing Management: Submit accurate claims, handle denials and rejections, and ensure all claims have complete and accurate diagnosis and procedure codes.
• Cross-functional Collaboration: Work closely with clinical teams to resolve missing or inconsistent documentation and collaborate with technology teams on claims generated via algorithmic processes.
• Reporting & Transparency: Generate and share regular claims status reports with senior management, providing visibility into revenue, accounts receivable, and cash collections.
• Patient Interaction: Ensure accurate patient registration, verify insurance eligibility, and collect necessary cost-sharing amounts.
• Problem-Solving & Initiative: Identify trends in denials and proactively address issues to improve overall claims processing efficiency.
• Adaptability & Resilience: Thrive in a growing practice and adjust to evolving responsibilities, contributing to a flexible and dynamic work environment.