Revenue Cycle Specialist
About The Position
The Revenue Specialist plays a crucial role in the Revenue Operations team, reporting directly to the Revenue Operations Supervisor. This involves actively reviewing and validating claim information, promptly correcting billing errors to maintain data precision, analyzing denied claims to identify reasons for denial, and implementing workflow and procedural enhancements to minimize denials. The role also includes collaborating with the billing team to address claim submission discrepancies, contributing to denial management efforts, actively participating in revenue optimization initiatives, and fostering close teamwork for a cohesive and cooperative approach to achieving optimal financial performance. This position is NOT remote - this is an In-Office position. The role encompasses information management, including record management, subpoena response, and credentialing responsibilities. This involves both new and re-credentialing processes. Denial Management: Analyze denied claims to identify reasons for denial. Promptly correct billing errors to maintain data precision. Payer Outreach: Contacting payers to gather information on claim denials. Process Improvement: Assist with implementing revenue-related processes and strategies to enhance operational efficiency. Collaboration: Collaborating with partner leadership, corporate leadership, the billing team, IT, and payers to resolve issues. Credentialing: Collaborate with relevant partner-level staff to collect, submit, and/or verify required credentials. Initiate credentialing and re-credentialing processes for applicable clinical staff and maintain working status. Information Management: Facilitate the release of medical records to authorized personnel, including clients, healthcare facilities, and insurance companies. Respond to subpoenas and court orders, ensuring accurate coordination and legal compliance. Uphold the highest standards of privacy, security, and legal requirements, particularly within the scope of HIPAA. Facility: Support facility licensing and enrollment process. Contracts: Support the contract management process. Teamwork: Foster close teamwork for a cohesive and cooperative approach to achieving optimal financial performance. Reporting: Contribute to regular reporting on key performance indicators (KPIs) related to revenue processes. Meetings: Attend and actively contribute to staff meetings within the Revenue Operations team. Training: Attend relevant training to stay updated on industry best practices, regulatory changes, and emerging trends. This description outlines the general scope and level of work for this role. It is not intended to include every duty or responsibility that may be required of employees in this position. Compensation Competitive hourly pay aligned with your role, experience, and contribution, with opportunities for growth over time. Compensation: $18.93 - $24.30 Placement within the range is based on licensure level, education, and experience. What You Can Expect Review claims, fix billing issues, and help reduce claim denials. Work with insurance payers, billing teams, and staff to solve problems and improve processes. Support credentialing, medical records, licensing, and other revenue operations tasks. Be part of a collaborative in-office team focused on accuracy, compliance, and excellent service.
Requirements
- Basic knowledge of denial management processes is required.
- 1-3 years of experience in a similar role within healthcare revenue operations, billing, or claims processing is preferred.
Nice To Haves
- Bachelor's Degree
Responsibilities
- Review and correct claims to ensure accurate billing and timely payments.
- Investigate claim denials and work with insurance payers to resolve issues.
- Manage credentialing, medical records, and compliance-related documentation.
- Collaborate with team members to improve revenue processes and support daily operations.
Benefits
- Consumer-driven health plan coverage provided by Anthem
- Wellness: When you enroll in a medical plan, you get complete care support on your time through Sydney app (Anthem), with exclusive access to 24/7 access to licensed doctors, therapists, and psychiatrists.
- Health Savings Account (HSA) or Flex Spending Account (FSA)
- Two dental plan options available through Delta Dental
- Affordable vision plan available through EyeMed
- An optional Dependent Care Flexible Spending Account
- Generous paid time off
- 401k or Roth IRA Retirement Programs administered by Empower
- Financial planning and education services at no cost to you
- Voluntary supplemental benefits (Accident, Critical Illness, Short-Term Disability)
- Educational Assistance
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
