Job Overview
We are seeking a detail-oriented and proactive Revenue Cycle Specialist to join our healthcare administration team. The ideal candidate will possess a comprehensive understanding of medical billing, coding, and revenue cycle management processes. This role is vital in ensuring accurate and timely reimbursement for healthcare services by managing claims processing, denials, and collections efficiently. The Revenue Cycle Specialist will work closely with clinical staff, insurance companies, and patients to optimize revenue flow while maintaining compliance with industry standards and regulations.
Responsibilities
- Review and process medical claims using appropriate coding systems such as CPT (Current Procedural Terminology), ICD-9, ICD-10, and DRG (Diagnosis-Related Group) classifications to ensure accurate billing.
- Verify patient insurance information and eligibility to facilitate seamless claim submission and reimbursement.
- Utilize Electronic Medical Record (EMR) and Electronic Health Record (EHR) systems to document medical records accurately and support billing activities.
- Follow up on unpaid or denied claims through effective medical collection strategies, appealing when necessary to maximize revenue recovery.
- Ensure compliance with medical coding standards, including ICD coding updates and proper application of DRG codes for inpatient services.
- Collaborate with clinical staff to clarify documentation requirements for accurate coding and billing purposes.
- Maintain detailed records of billing activities, claim submissions, adjustments, and collections in accordance with regulatory guidelines.
- Stay informed about industry changes related to medical terminology, coding updates, and healthcare regulations affecting the revenue cycle process.
Qualifications
- Proven experience in medical billing, medical coding, or revenue cycle management within a healthcare setting.
- Strong knowledge of CPT coding, ICD-9/ICD-10 coding systems, DRG classifications, and medical terminology.
- Familiarity with EMR/EHR systems used for documentation and billing processes.
- Experience in handling medical records management and ensuring documentation accuracy for billing purposes.
- Excellent understanding of insurance verification procedures and medical collection practices.
- Ability to interpret complex medical documentation accurately for coding and billing accuracy.
- Prior experience working in a fast-paced environment with strong organizational skills is preferred.
- Knowledge of healthcare regulations related to billing compliance is an asset. Join our team as a Revenue Cycle Specialist to play a crucial role in optimizing the financial health of our healthcare organization through precise coding, effective collections, and seamless revenue management!
Pay: From $19.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Referral program
- Vision insurance
Work Location: In person
