Revenue Cycle Operations Specialist

FRC•Fairfax, VA

2d•Hybrid

About The Position

Fairfax Radiology Centers (FRC) is seeking a detail-oriented, resourceful, and solutions-driven Revenue Cycle Operations Specialist to support revenue cycle operations and patient care. The role connects internal departments, external billing partners, insurance payers, and affiliated organizations, resolving complex billing and reimbursement issues and coordinating payer enrollment for imaging locations, equipment, and services. The specialist supports billing and reimbursement operations, facility and equipment enrollment, legacy accounts receivable resolution, and revenue cycle systems and process improvement. The position is hybrid, initially requiring on-site work 1–2 days per week, with potential for increased remote flexibility based on departmental needs. This is an internal posting for current FRC employees only.

Requirements

Associate degree or higher in Healthcare Administration, Health Sciences, Information Technology, or a related field, plus at least two years of experience in healthcare revenue cycle operations, medical billing, payer relations, or a related field; an equivalent combination of education and experience will be considered.
Experience with healthcare insurance and revenue cycle operations, including claims processing, payer reimbursement, and billing workflows.
Familiarity with institutional or facility billing requirements, including UB-04 claims.
Proficiency in Microsoft Excel, including PivotTables and VLOOKUP, and ability to analyze and interpret payer and reimbursement data.
Strong research, problem-solving, organizational, and communication skills.
Ability to manage multiple priorities and collaborate effectively with internal and external partners.

Nice To Haves

Experience with facility, site, equipment, or provider enrollment, credentialing, and recredentialing.
Experience in institutional or facility billing, managed care, or payer contracting.
Experience researching credit balances, account adjustments, payment discrepancies, and reconciliation issues.
Professional certification related to healthcare revenue cycle, billing, coding, or reimbursement.

Responsibilities

Research and resolve complex billing, insurance, reimbursement, and operational questions for external billing vendors and internal departments.
Investigate payer denials, underpayments, authorization issues, claims-processing discrepancies, and other reimbursement challenges.
Coordinate resolution of payer and billing issues with Inova, external billing partners, and internal teams.
Support institutional and facility billing, including UB-04 claims, payer requirements, and reimbursement processes.
Coordinate recurring revenue cycle meetings with Inova and track outstanding issues and action items through resolution.
Support Hospitality Associates and other internal departments with questions about insurance coverage, payer participation, services, and billing workflows.
Maintain accurate internal payer information, billing resources, and operational guidance.
Coordinate insurance payer enrollment and recredentialing for imaging facilities, including new locations, relocations, demographic changes, and organizational updates.
Support enrollment and credentialing of imaging equipment and services, including documentation, accreditation information, and payer notifications.
Track enrollment submissions, effective dates, deadlines, and outstanding requirements.
Partner with internal departments, Inova, and external billing and credentialing resources to establish new locations, equipment, and services with payers.
Research and resolve enrollment-related denials, payer directory discrepancies, network participation issues, and reimbursement concerns.
Coordinate provider credentialing documentation and follow-up with internal and external partners.
Research and resolve outstanding legacy accounts receivable, including payer balances, denials, underpayments, adjustments, and payment discrepancies.
Analyze credit balances, payments, and account activity to determine appropriate resolution, including refund eligibility.
Perform account reconciliation, payment posting, adjustments, and other legacy accounts receivable activities as needed.
Review and process approved account write-offs in accordance with established policies and documentation requirements.
Coordinate patient refunds with Patient Financial Services.
Identify recurring reimbursement issues and support corrective actions to improve account resolution and reduce revenue risk.
Investigate system, workflow, configuration, and data issues affecting billing, claims processing, payer enrollment, and reimbursement.
Participate in revenue cycle system upgrades, testing, data validation, and implementation of new technology.
Support future EMR/EHR implementations, including workflows related to scheduling, registration, payer setup, eligibility, and billing.
Evaluate reimbursement for new contrast agents and imaging tracers by comparing acquisition costs with expected payer reimbursement.
Support special billing arrangements, pricing changes, payer correspondence, and implementation of new services or modalities.
Assist with revenue integrity reviews, account audits, and identification of potential revenue leakage.
Identify opportunities to streamline processes, strengthen operational controls, and improve coordination across revenue cycle teams.