Revenue Cycle Management Specialist

Trilogy Careers•Skokie, IL

3d•Hybrid

About The Position

The Revenue Cycle Management Specialist is responsible for timely submission of claims to insurance companies for a wide variety of medical providers and facilities, addressing denials, and following up to ensure payments for medical services are received promptly and in full. The specialist may serve as an intermediary among healthcare providers, clients, patients, and health insurance companies. This position follows a Monday–Friday schedule, 8:00 a.m.–4:30 p.m., with a hybrid arrangement requiring three days per week in the office (Tuesday–Thursday). The office is located at 5250 Old Orchard Rd., Skokie, IL 60077. The pay range is $27.88–$32.07 per hour.

Requirements

High school diploma or equivalent.
At least 3 years of experience in the healthcare industry, particularly working with Medicaid and Managed Medicaid insurance companies.
Educated on and compliant with HIPAA regulations.
Understanding of medical terminology and ability to maintain strict confidentiality of patient and client information.
Strong understanding of Microsoft applications, including Excel, Outlook, Word, and PowerPoint.
Ability to investigate problems and develop and communicate solutions.
Ability to provide excellent, professional customer service to internal and external customers.
Must have received or be willing to receive the COVID-19 vaccination by the date of hire; proof of vaccination is required.

Nice To Haves

Bachelor’s degree in Business Administration, Accounting, or Health Care Administration.
Medical billing, medical coding, or medical administration certificate or diploma program.
One to three years of training and experience in Revenue Cycle functions.
Experience with the CareLogic system.

Responsibilities

Review client accounts for accuracy and completeness.
Obtain missing information and submit claims to insurance companies and other payer sources for payment.
Identify the insurance company or correct guarantor to bill, and identify and bill primary, secondary, or tertiary insurance.
Use client electronic health records and paper records to assist with billing and collections.
Maintain accurate and legally compliant health records.
Review insurance payments for accuracy and compliance with contract discounts.
Review denied or partially paid claims and work with involved parties to resolve discrepancies.
Manage assigned accounts to ensure outstanding or pending claims are paid in a timely manner, and contact appropriate parties to collect payment.
Communicate with healthcare providers, patients, insurance claim representatives, and other parties to clarify billing issues and facilitate timely payment.
Consult supervisors, team members, and appropriate resources to resolve billing and collection questions and issues.
Maintain work operations and quality by following standards, policies, and procedures; escalate compliance issues to the Supervisor.
Prepare reports and forms as directed and in accordance with established policies.
Perform other related duties and projects as assigned.

Benefits

Free virtual primary care, urgent care, and mental health counseling for all employees.
Paid maternity and paternity leave.
Medical insurance (BCBS of IL).
Dental insurance.
Vision insurance.
Life insurance.
Long-term and short-term disability.
Pet insurance.
Flexible spending accounts for health, dependent care, and transit.
Telemedicine.
Employee Assistance Program (EAP).
403(b) retirement plan with employer match.