Revenue Cycle Specialist Jobs

About The Position

Requirements

• At least 2 years of progressive revenue cycle management (RCM) billing and coding experience.
• At least 1 year of customer service/client relations and employee training experience.
• Excellent computer skills, including strong proficiency with web-based and SaaS applications.

Nice To Haves

• Associate or bachelor's degree preferred.
• CPC, CPB, or equivalent certification highly preferred.

Responsibilities

• Review and validate claims for accuracy, completeness, and compliance before submission, including required coding, modifiers, and authorizations.
• Submit claims through clearinghouses or payer portals in a timely manner and meet claim-processing and submission productivity benchmarks and KPIs.
• Review claim edits and scrubbing rules to identify errors before submission.
• Correct claim issues related to coding, modifiers, eligibility, or missing information.
• Monitor clearinghouse edits and rejections and payer rejection reports daily; research and resolve rejected claims promptly.
• Identify root causes of rejections, implement corrective actions, track rejection trends, and escalate systemic issues.
• Stay current on payer-specific billing requirements, edits, and submission guidelines, and ensure claims comply with payer guidelines, regulatory requirements, and internal SOPs.
• Maintain accurate documentation of claim activity and corrections.
• Identify recurring claim errors, rejection patterns, and workflow inefficiencies, and provide improvement feedback to leadership and cross-functional teams.
• Support onboarding of new clients or payers by ensuring proper claim setup and workflows.
• Communicate directly with clients through tasks to resolve claim-related issues and collaborate with internal teams on claim resolution.
• Maintain HIPAA compliance when handling patient protected health information (PHI).

Benefits

• Medical insurance coverage options, including an employer-sponsored subsidy toward employee medical insurance premiums.
• Dental insurance.
• Vision insurance.
• Life insurance; Azalea Health covers 100% of Life AD&D premiums for eligible full-time employees.
• Long-term disability; Azalea Health covers 100% of premiums for eligible full-time employees.
• Paid time off (PTO) with flexible use.
• Competitive pay and advancement opportunities.