Revenue Cycle Specialist I

Community Health Center of Central Wyoming•Casper, WY

About The Position

Review and submit medical encounters to insurance companies for payment. The Revenue Cycle Specialist I works directly with providers, insurance companies, and patients to support timely claim processing and payment, and answers billing questions and inquiries. The position requires attention to detail, multitasking and prioritization skills, and excellent customer service. Work is performed in a typical medical clinic and business office environment, primarily indoors, with prolonged periods of sitting, typing, and viewing a computer monitor. Some automobile travel and short-term assignments at other sites may be required. The role may involve exposure to blood and body fluids, chemicals, and infectious pathogens; protective equipment must be used as required. Successful completion of substance abuse testing is a condition of employment.

Requirements

High school diploma or equivalent.
1–3 years of medical billing and coding experience.
Ability to perform the essential duties satisfactorily.
Ability to maintain the confidentiality of sensitive patient information.
Attention to detail, ability to multitask and prioritize, and excellent customer service skills.
Ability to drive, handle paperwork, operate computer equipment, and communicate effectively in writing and orally.
Ability to use protective equipment as required.
Successful completion of substance abuse testing as a condition of employment.

Responsibilities

Review assigned open claims daily to ensure they are ready for insurance submission, including accurate ICD-10 and HCPCS/CPT coding and required documentation.
Query providers when code assignments are unclear or documentation is inadequate or incomplete.
Submit secondary billing promptly with supporting documentation.
Review, work, and appeal denied or unpaid claims.
Accurately post patient payments to the appropriate accounts.
Manage collections and unpaid accounts by establishing and monitoring patient payment arrangements, following up on missed payments, and referring accounts to outside collection agencies when necessary.
Resolve patient billing and collections inquiries and issues, including in-person visits and phone calls.
Run, work, and manage assigned patient and/or insurance group accounts receivable reports and credit reports.
Identify and analyze billing issues or trends and communicate them to appropriate personnel.
Contact insurance companies when necessary.
Maintain knowledge of insurance policies, guidelines, and applicable code sets.
Perform other duties as assigned by the supervisor.