Revenue Cycle Specialist

Unified Women's Healthcare•UNAVAILABLE, Virginia

About The Position

The Revenue Cycle Specialist is responsible for resolving claim issues including A/R denials, payment variances, and any other unresolved issues that may arise directly from internal and external customers. There is an expectation of consistent and clear communication to multiple internal and external entities to collaborate and resolve issues.

Requirements

High school diploma or equivalent
Minimum of 2 years current experience interpreting insurance explanation of benefits, patient benefit plans; policy coverage and patient responsibility
Minimum of 2 years current experience working with medical claims, billing and collections, and appeals; OB/GYN specialty preferred
Experience working with healthcare practice management systems, (Athenanet preferred)
Experience working with cloud-based Customer Relationship Management (CRM) technology (Salesforce preferred)
Experience with Microsoft Office with proficiency with Microsoft Excel
Excellent verbal and written communication skills with internal and external customers
Ability to collaborate effectively in a cross-functional team environment
Experience and knowledge of commercial and governmental insurance payer and clearinghouse portals (Availity, Navinet, Optum, etc.) including billing guidelines and policy updates
Working knowledge of Medical Billing & Coding required

Nice To Haves

post secondary degree preferred
Certification preferred

Responsibilities

Resolve Accounts Receivable and Collections, including Review, Follow Up, and Appeal denied claims according to standards
Determine accuracy of Insurance payments and follow up on discrepancies
Initiate, Follow Up, and Respond on payer reimbursement issues
Communicate with Practices and Payers regarding claim denials and payer trends
Analysis and Quality Review of work completed by third parties
Build and generate reports, as needed