Senior Revenue Cycle Specialist

Necco•Cincinnati, OH

About The Position

The Senior Revenue Cycle Specialist serves as the operational lead and subject matter expert for Revenue Cycle functions including per diem billing, fee-for-service billing, claim reconciliation denial management, appeals, accounts receivable follow-up, credentialing support, and revenue cycle process improvement. The Senior Revenue Cycle Specialist provides workflow guidance, training support, quality oversight, and operational leadership while partnering with the Revenue Cycle Manager to improve reimbursement outcomes, reduce denials, standardize processes, and support financial sustainability. This position provides operational leadership and workflow support but does not have direct supervisory responsibility.

Requirements

Minimum of five (5) years of experience in healthcare revenue cycle operations, with demonstrated expertise in billing, accounts receivable follow-up, denial management, and reimbursement recovery
Experience with EHR and clearinghouse systems
Strong analytical, problem-solving, communication, and leadership skills, including experience training or mentoring team members
Successful completion of all required criminal background checks
Valid driver’s license and state minimum auto insurance

Nice To Haves

Experience with Medicaid, Managed Care Organizations (MCOs), and governmental billing; behavioral health and per diem billing experience preferred
Credentialing and enrollment experience and experience leading process improvement projects preferred
CPC, CPB, CRCR, or similar professional certification preferred

Responsibilities

Act as lead resource and subject matter expert for Revenue Cycle operations
Assist in establishing department standards, workflows, and best practices
Provide guidance, training, onboarding, and cross-training support to Revenue Cycle team members
Use data, trends, and root cause analysis to identify operational risks and reimbursement barriers and support measurable improvement
Communicate effectively with team members, leadership, payers, and operational partners to resolve issues and support collaboration
Assist Revenue Cycle Manager with special projects and strategic initiatives
Serve as subject matter expert for per diem billing processes
Monitor billing timeliness and accuracy and identify and resolve billing issues impacting reimbursement
Collaborate with operational teams to resolve authorization, census, and invoicing concerns
Develop standardized billing procedures and training materials
Serve as operational lead for fee-for-service (FFS) billing activities
Review billing workflows and identify opportunities to improve accuracy and reimbursement
Monitor claim submission performance
Provide support for complex billing issues and claim corrections
Perform and oversee charge reconciliation processes
Validate that services rendered are accurately reflected in billing systems and identify missing charges or revenue leakage
Collaborate with clinical and operational teams to resolve discrepancies
Recommend process improvements to reduce missed billing opportunities
Lead investigation and resolution of complex denials
Analyze denial trends and develop appeal strategies
Prepare and submit high-value appeals
Monitor appeal outcomes and identify opportunities for improvement
Serve as escalation point for reimbursement disputes
Monitor aging accounts receivable and support reduction of aged balances
Assist team members with complex reimbursement issues
Review productivity and reimbursement trends
Escalate payer issues as needed
Serve as Revenue Cycle liaison for credentialing-related reimbursement issues
Monitor credentialing impacts on billing and reimbursement and support escalation of enrollment and payer participation concerns
Assist with development of credentialing workflows and tracking processes.
Provide backup support during staffing gaps
Review coding-related billing trends and denial patterns and identify opportunities for coding education and documentation improvement
Collaborate with providers, operations, and leadership to address recurring coding concerns
Assist with implementation of coding-related billing edits and workflow improvements
Stay informed of coding and payer requirements affecting reimbursement
Perform quality reviews of billing, payment posting, appeals, and accounts receivable follow-up activities with a focus on accuracy, accountability, and attention to detail
Monitor compliance with organizational policies and payer requirements
Assist with auditing and quality improvement initiatives
Lead workflow standardization efforts and develop and maintain department job aids and process documentation
Assist with KPI development and monitoring and use results to identify barriers and support measurable outcomes
Recommend automation and efficiency opportunities
Participate in EHR and system improvement initiatives
Supports timely and accurate billing, claim submission, payment posting review, and accounts receivable follow-up activities
Contributes to reduced denials, improved appeal outcomes, decreased aged receivables, and increased reimbursement recovery
Maintains consistent workflow documentation, job aids, and training resources that support team efficiency and cross-training
Demonstrates measurable progress toward departmental goals, quality standards, process improvements, and financial sustainability
Models Necco’s mission, vision, and values through professionalism, ownership, collaboration, and measurable results
Maintains a solution-focused approach when working with internal teams, external partners, and cross-functional stakeholders
Protects confidentiality and supports compliance with organizational policies, payer requirements, and regulatory expectations
Contributes to a positive team culture by demonstrating accountability, respect, continuous learning, and commitment to building families