Revenue Cycle Specialist (Hybrid)
About The Position
Sadler Health Center is seeking a detail-oriented and proactive Revenue Cycle Specialist to join our team. As a Revenue Cycle Specialist, you will be responsible for the billing process, verifying insurance coverage, and ensuring accurate submission of claims. This role is crucial in maximizing revenue and maintaining efficient billing operations for our organization. As a Revenue Cycle Specialist, you will verify patient insurance coverage as needed and review patient accounts to identify missed billing opportunities. You will create claims, submit claims to insurance payers electronically and by paper and review claims for accuracy prior to submission. You will also confirm the accuracy of sliding fee discount adjustments and post and reconcile payments to patient accounts. Our Revenue Cycle Specialists also respond to inquiries regarding billing and patient accounts from patients, families, insurance companies, Medicaid offices, and associated managed care plans, Medicare, and their HMOs/MA programs. You will review claim denials as well as prepare and submit refund requests. As well as collaborating with clinical staff to resolve billing issues BS and follow up with the appropriate parties regarding outstanding claims and denials. You will also contact patients to resolve insurance claims and collect outstanding balances. You will also provide financial counseling and establish payment plans with patients.
Requirements
- High School Diploma/GED
- Minimum of one year of customer service experience
- At least one year of experience working or handling third party reimbursements with ICD-10 and CPT/CDT Coding and medical/dental billing experience
Nice To Haves
- An associate degree in a related field or certificate of completion of an accredited healthcare/medical billing certification program
- An active AAPC Certified Professional Coder designation
- Work experience of cashier experience which included completing reconciliation of deposits
Responsibilities
- Verify patient insurance coverage as needed
- Review patient accounts to identify missed billing opportunities
- Create claims
- Submit claims to insurance payers electronically and by paper
- Review claims for accuracy prior to submission
- Confirm the accuracy of sliding fee discount adjustments
- Post and reconcile payments to patient accounts
- Respond to inquiries regarding billing and patient accounts from patients, families, insurance companies, Medicaid offices, and associated managed care plans, Medicare, and their HMOs/MA programs
- Review claim denials
- Prepare and submit refund requests
- Collaborate with clinical staff to resolve billing issues BS
- Follow up with the appropriate parties regarding outstanding claims and denials
- Contact patients to resolve insurance claims and collect outstanding balances
- Provide financial counseling and establish payment plans with patients
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
