Sr. Revenue Cycle Specialist, Day Shift, Ambulatory

Adventist HealthCare•Gaithersburg, MD

About The Position

The Sr. Revenue Cycle Specialist supports ambulatory revenue-cycle and billing operations. The role verifies and corrects insurance information, charges, and coding issues for electronic claims and manual corporate billing, and ensures billing follows payer requirements. The specialist follows up on appeals, payment errors, low reimbursement, denials, and other billing issues; reviews explanations of benefits (EOBs); and resolves patient billing calls and inquiries. The position also reconciles billing activity and works to eliminate backlogs. It analyzes performance, identifies trends and improvement opportunities, and reports key metrics such as accounts-receivable days, cash collections, denials, avoidable write-offs, refunds, charge lag, and bad debt. The specialist coordinates with accounting to support accurate and timely month-end financial reports and troubleshoots operational issues, reporting them to management or initiating resolution as appropriate. This is a full-time, day-shift position scheduled Monday through Friday for 40 hours per week. There are no weekend requirements; holidays follow the company holiday calendar. The position is non-exempt and has a stated pay range of $26.00–$39.00.

Requirements

Bachelor’s or associate degree in Finance, Business, or Accounting, or equivalent experience.
Seven years of experience in this field.
Experience with Electronic Health Records software.
Ability to maintain high-volume processing without compromising quality and accuracy.

Nice To Haves

Certified medical coder certification is a plus.
eClinical Works experience is desirable.

Responsibilities

Verify and correct insurance information, charges, and coding issues for electronic claims and manual corporate billing.
Ensure billing guidelines are followed according to payer requirements.
Contact insurance companies about the status of appeals.
Perform daily reconciliation and work to eliminate billing backlogs.
Follow up on payment errors, low reimbursement, denials, and related issues.
Review EOBs and initiate appeals as necessary.
Resolve patient billing calls and inquiries.
Troubleshoot billing-operations issues, report them to management, and/or initiate resolution.
Analyze performance, identify trends and opportunity areas, and prioritize performance-improvement initiatives across areas such as coding, claim submission, insurance and self-pay collections, refunds, and write-off approvals.
Routinely report key metrics, including AR days, cash collections, denials, avoidable write-offs, refunds, charge lag, and bad debt.
Coordinate with accounting to ensure accurate and timely month-end financial reports.
Maintain high-volume processing while preserving quality and accuracy.

Benefits

Work-life balance through nonrotating shifts.
Recognition and rewards for professional expertise.
Free employee parking.
Medical, prescription, dental, and vision coverage for employees and eligible dependents effective on the date of hire.
Employer-paid short- and long-term disability, basic life insurance, and AD&D; short-term disability buy-up is available.
Paid time off.
Employer retirement contribution and match after one year of eligible employment, with a three-year vesting period.
Voluntary benefits including flexible spending accounts, legal plans, life insurance, pet insurance, auto insurance, home insurance, long-term care insurance, and critical illness and accident insurance.
Subsidized childcare at participating childcare centers.
Tuition reimbursement.
Employee Assistance Program (EAP) support.