Revenue Cycle Specialist I

Community Health Center of Central Wyoming•Casper, WY

7d•$19 - $24

About The Position

Review and submit medical encounters to insurance companies for payment, working directly with providers, insurance companies, and patients to support timely claim processing and payment. The role also answers billing inquiries and requires attention to detail, multitasking, prioritization, and strong customer service skills. The position works with patient and insurance accounts, including claims submission and follow-up, payment posting, collections, and billing issue resolution. It requires handling sensitive and confidential patient information. Work is performed primarily indoors in a typical medical clinic and business office environment, with prolonged sitting, typing, and computer-monitor use. Some automobile travel or short-term assignment at another site may be required. The clinical setting 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. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

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.
Ability to drive, handle paperwork, operate computer equipment, and communicate effectively in writing and orally with patients, staff, and the public.
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 submission to insurance.
Ensure accurate ICD-10 and HCPCS/CPT code assignment and confirm that documentation requirements for billed and coded procedures are met.
Query providers when code assignments are unclear or documentation is inadequate or incomplete.
Submit secondary billing promptly with all supporting documentation.
Review, work, and appeal denied or unpaid claims.
Accurately post patient payments to appropriate accounts.
Handle collections and unpaid accounts by establishing and monitoring payment arrangements, following up on missed payments, and sending accounts to outside collection agencies when patients fail to establish or comply with payment plans.
Resolve patient billing and collections inquiries and issues, including in-person visits and phone calls.
Run, work, and manage assigned patient or insurance group accounts receivable reports.
Run, work, and manage assigned patient or insurance group 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.