Revenue Cycle Specialist - Self Pay (REMOTE)

Overview

This remote position as a Revenue Cycle Specialist - Self Pay supports various aspects of the healthcare revenue cycle process, including claims submission, billing, coding, payment posting, and accounts receivable management. The role focuses on ensuring timely and accurate reimbursement by identifying and resolving claim issues, following up with payers, and maintaining compliance with payer and regulatory guidelines.

Responsibilities

• Review and submit claims to payers, ensuring accuracy and adherence to guidelines.
• Identify and resolve claim denials and rejections by researching root causes, correcting errors, and resubmitting claims.
• Assist with payment posting and reconciliation to ensure accuracy and resolve discrepancies.
• Follow up on outstanding accounts receivable balances, working with payers to expedite payments and resolve issues.
• Review coding and billing for accuracy, collaborating with team members to address discrepancies and ensure proper use of CPT, ICD-10, and HCPCS codes.
• Monitor payer requirements and update processes to maintain compliance with policy and regulatory changes.
• Maintain accurate documentation of revenue cycle activities, including claim follow-up, denial resolution, and payment posting.
• Perform other duties as assigned.
• Maintain regular and reliable attendance.
• Comply with all organizational policies and standards.

Qualifications

• High School Diploma or GED required.
• Associate Degree in Healthcare Administration, Business, or related field preferred.
• 1-3 years of experience in healthcare revenue cycle operations, including claims processing or accounts receivable management required.
• Experience with claim denials and payer reimbursement processes preferred.
• Familiarity with electronic health record (EHR) systems and revenue cycle software preferred.

Knowledge, Skills, and Abilities

• Understanding of revenue cycle processes such as claims submission, payment posting, and accounts receivable management.
• Basic knowledge of healthcare billing and coding, including CPT, ICD-10, and HCPCS codes.
• Strong attention to detail and problem-solving skills for resolving claim and payment issues.
• Organizational skills to manage tasks, prioritize workload, and meet deadlines.
• Effective verbal and written communication skills for collaboration with team members and payers.
• Knowledge of HIPAA and other regulatory requirements impacting the revenue cycle.
• Proficiency with revenue cycle software, EHR systems, and Microsoft Office applications.

Compensation and Benefits

• Comprehensive health coverage including medical, dental, and vision plans.
• 401(k) retirement plan with matching contributions.
• Student loan repayment assistance up to $10,000.
• Educational tuition assistance.
• Competitive salary and full benefits package designed to reward expertise and dedication.

Location

This is a remote position supporting healthcare revenue cycle operations.