Revenue Cycle Specialist

Overview

This full-time Revenue Cycle Specialist position supports the hospital revenue cycle billing department by managing collection activities for assigned accounts receivable segments. The role is telecommuting with a Monday to Friday, 8am-5pm schedule.

Responsibilities

• Perform follow-up on outstanding insurance balances and take necessary actions for account resolution in compliance with federal and state regulations.
• Contact assigned accounts daily to provide effective collection follow-up.
• Batch, compile, and submit appeals; monitor accounts to ensure proper reimbursement.
• Achieve and maintain accounts receivable days at established goals.
• Communicate effectively with employers, healthcare providers, insurers, and patients/families to obtain accurate information and maximize reimbursement.
• Verify charge accuracy and correct account errors through telephone and mail communication.
• Monitor and track contractual, billing, registration, and posting errors; provide feedback to department supervisor.
• Verify applicable contracts by reviewing Explanation of Benefits (EOB) messages, patient ID cards, and member information for managed care plans.
• Maintain detailed documentation in the collection system regarding actions taken or promises made.
• Perform miscellaneous job-related duties as requested.

Requirements

Education

• Associate's degree in healthcare, business, or a closely related field, or equivalent work experience.

Experience

• Minimum of two years of experience in collection activities and accounts receivable reduction within a healthcare setting.

Skills

• Effective time management and ability to multitask.
• Strong proficiency in Microsoft Office, especially Excel.
• Knowledge of payer or governmental requirements related to revenue cycle processes.

Preferred Qualifications

• Experience with AHCCCS billing laws and regulations, third-party and managed care payer billing requirements, registration, verification, and centralized computer systems.
• Familiarity with medical terminology and HIPAA regulations.
• Credentialed Revenue Cycle Representative certification.
• Certified Patient Account Representative certification.

Physical Requirements and Occupational Exposure

• Occasional climbing, sensing textures and temperatures, stooping, crouching, kneeling, and crawling.
• Frequent pushing/pulling, reaching, standing, lifting up to and more than 35 pounds without assistance.
• Constant fine motor skills, hearing, talking, walking, near vision, use of keyboard/mouse/computer equipment, and sitting.
• Frequent far vision.
• Work performed in an inside office environment, including confined areas.

Location

This position is telecommuting.

Category

Patient Financial Services

Shift

Monday to Friday, 8:00 AM to 5:00 PM

Employment Type

Full-Time