Revenue Cycle Management Specialist

Arete' Health PT•Remote,

2d•Remote

About The Position

The Revenue Cycle Specialist is responsible for the management of the financial lifecycle of patient care, ensuring accurate billing, timely claims processing, and timely reimbursement for services.

Requirements

High school diploma or equivalent required; associate or bachelor’s degree preferred.
Two or more years of medical billing experience.
Excellent attention to detail, organizational skills, and ability to manage deadlines.
Proficiency with Microsoft Office applications.
Strong analytical and problem-solving skills.
Clear professional written and verbal communication.
Ability to interpret payer and regulatory requirements.
Effective time management and prioritization.
Collaborative and service-oriented mindset.

Responsibilities

Posts payments, adjustments, and denials from all payers and patients.
Ensures all transactions are recorded promptly and accurately in accordance with internal accounting policies.
Identifies and payments not being paid at the allowed/contracted amount and communicates this to the Director.
Process demographic, tax, banking (EFT) updates in a timely manner.
Audit insurance and patient accounts to determine if refund is needed, and process refunds if appropriate.
Downloads and distributes all correspondence, EOB’s, and ERA’s as received from all sources (Mail, Payer Portals, Banking Lockbox, Fax, Email).
Manage patient billing inquiries, set up payment plans, and follow up on outstanding balances.
Engage directly with patients to explain their bills, resolve billing inquiries, and establish payment for outstanding balances, ensuring a positive patient experience.
Generate monthly patient statements.
Prepare and correct claims to cleanly pass from the EMR to clearinghouse.
Perform posting of charges and completion of claims to payers in a timely manner.
Resolve patient accounts through the correction of billing edits and clearinghouse rejections.
Navigate portals to send claims for adjudication.
Prepare invoices to send to third party payers.
Generate reports on revenue cycle performance to identify trends in payments, denials, and accounts receivable.
Partner with all internal and external RCM teams to ensure seamless integration and operations of revenue cycle functions.
Perform other duties as assigned by the Billing Director, contributing to special projects, process improvements, and operational readiness.