Revenue Cycle Specialist (Full-Time, On-Site)
Position Summary:
Dunkirk Family Practice is seeking a detail-oriented and motivated Revenue Cycle Specialist to join our team. This full-time, on-site position plays a vital role in ensuring the financial health of our practice by managing insurance claims, patient accounts, payment processing, and revenue recovery activities.
The ideal candidate will have strong knowledge of medical billing and insurance reimbursement processes, excellent customer service skills, and the ability to work independently while contributing positively to a collaborative team environment.
Essential Duties and Responsibilities:
Insurance Claims Management
- Submit insurance claims electronically through clearinghouses or directly to insurance carriers, as well as via paper CMS-1500 forms when necessary.
- Investigate and follow up on unpaid, underpaid, denied, or rejected claims to ensure timely reimbursement.
- Research claim discrepancies, resolve coding or billing issues, and resubmit corrected claims as appropriate.
- Prepare and submit appeals for denied claims, including gathering supporting documentation and drafting appeal letters.
- Process secondary insurance claims after primary insurance adjudication.
Patient Account Management
- Apply and post patient payments accurately and efficiently.
- Review and manage patient account balances, ensuring accuracy and timely resolution of outstanding balances.
- Assist patients with questions regarding charges, copayments, deductibles, coinsurance, write-offs, and other patient-responsible amounts.
- Establish payment arrangements for eligible patients in accordance with practice policies.
- Address billing concerns professionally and explain insurance coverage determinations when services are not covered.
Reporting and Compliance
- Generate and review insurance and patient aging reports.
- Maintain compliance with HIPAA regulations and confidentiality standards when handling protected health information.
- Ensure accurate documentation and recordkeeping within the practice management and electronic medical record systems.
- Stay current on payer guidelines, insurance requirements, and reimbursement regulations.
Qualifications and Skills
- Working knowledge of medical billing, insurance claims processing, and reimbursement methodologies.
- Familiarity with electronic claim submission through clearinghouses and direct payer portals.
- Strong understanding of insurance benefits, claim denials, appeals, and payment posting.
- Excellent verbal and written communication skills.
- Strong customer service and patient relations skills.
- Accurate data entry and keyboarding skills.
- Strong mathematical and analytical abilities.
- Exceptional attention to detail and organizational skills.
- Ability to prioritize workload and manage multiple tasks simultaneously.
- Ability to work independently with minimal supervision.
- Collaborative team player with a positive and professional attitude.
Education and Experience:
Required:
- High School Diploma or GED
Preferred:
- Post-secondary education in Medical Billing, Healthcare Administration, or a related field
- Medical Billing and/or Coding Certificate
- Previous experience in a physician practice, medical billing office, or healthcare revenue cycle environment
Benefits
- Competitive pay based on experience
- Paid Time Off (PTO)
- Paid holidays
- 401(k)
- 401(k) matching
- Health insurance
- Dental insurance
- Health savings account
- Life insurance
- Professional development assistance
- Supportive team-oriented work environment
Schedule: Full-Time, Monday through Friday
Work Location: On-Site (Not Remote)
Pay: From $20.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Professional development assistance
- Retirement plan
Work Location: In person
