Revenue Cycle Specialist

2 weeks ago

Middle River, United States Johns Hopkins University Full time

The Department of Surgery is seeking an AR Revenue Cycle Specialist II that will be responsible for the collection of unpaid third-party claims and resolution of non-standard appeals, using various JHM applications and JHU/ PBS billing applications. Will conduct on-line research to locate information to resolve issues across different sub-specialties and/or relating to high-cost procedures. Communicates with payers to resolve issues and facilitate prompt payment of claims. Follow-up with insurance companies to collect outstanding accounts for which payment has not been received in response to the claim‘s submission process, either electronically or by paper. The Specialist will use a comprehensive knowledge of claims submission requirements for all payors in order to expedite payments. The Specialist will research and interpret medical policies regarding denials based on medical necessity. Will use a working knowledge of local coverage determinations (LCD‘s) to research and apply appropriately. Will mentor and advise junior specialists as appropriate.


Specific Duties & Responsibilities

  • Uses A/R follow-up systems and reports to identify unpaid claims for collection/appeal.
  • Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract.
  • Review and update patient registration information (demographic and insurance) as needed.
  • Resolves claim edits.
  • Drafts and resolves non-standard appeals.
  • Researches medical policies to resolve denials based on medical necessity.
  • Researches and applies LCD‘s.
  • Resolves issues across different sub-specialties and/or related to specialized, complex or high cosr procedures.
  • Applies appropriate discounts / courtesies based on department policy.
  • Prepares delinquent accounts for transfer to self-pay collection unit according to the follow-up matrix.
  • Prints and mails claim forms and statements according to the follow-up matrix.
  • Retrieves supporting documents (medical reports, authorizations, etc) as needed and submits to third-party payers.
  • Appeals rejected claims and claims with low reimbursement.
  • Confirm credit balances and gathers necessary documentation for processing refund.
  • Identifies insurance issues of primary vs. secondary insurance, coordination of benefits eligibility and any other issue causing non-payment of claims.
  • Contacts the payors or patient as appropriate for corrective action to resolve the issue and receive payment of claims.
  • Monitor invoice activity until problem is resolved.
  • Advises junior specialists as appropriate, confirms and assumes responsibility for escalated issues.
  • Identifies and informs the supervisor / Production Unit Manager of issues or problems associated with non-payment of claims and non-standard appeals.


Professional & Personal Development

  • Participate in on-going educational activities.
  • Keep current of industry changes by reading assigned material on work related topics.
  • Complete three days of training annually.


Service Excellence

  • Must adhere to Service Excellence Standards in the area of Customer Relations, Self-Management, Teamwork, Communications, Ownership/Accountability, and Continuous Performance Improvement.


Minimum Qualifications
  • High School Diploma or graduation equivalent.
  • Two years experience in a medical billing, insurance follow-up processing, or similar medical specialty environment.


Classified Title: AR Revenue Cycle Specialist II
Role/Level/Range: ATO 40/E/02/OD
Starting Salary Range: $16.20 - $28.80 HRLY ($50.000 targeted; Commensurate with experience)
Employee group: Full Time
Schedule: M- F, 9 - 5
Exempt Status:Non-Exempt
Location:Remote
Department name: SOM Sur Production Unit Billing
Personnel area: School of Medicine

  • Accounting Specialist

    2 weeks ago

    Middle River, United States Johns Hopkins University Full time

    We are seeking Accounting Specialist who will be responsible for maintaining the accuracy and integrity of timely reconciliation for all incoming and outgoing revenue for CPA physicians billing departments. Duties include overseeing and analyzing incoming and outgoing revenue of $550 million annually, maintaining various spreadsheets to document and track...

  • Cycle Counter

    6 days ago

    Fall River, United States Metalcraft of Mayville, Inc Full time

    Cycle Counter/Inventory Control - Fall River, WI 1st ShiftJob LocationsUS-WI-Fall RiverJob ID2024-3798# of Openings1CategoryManufacturingTypeRegular Full-TimeOverviewCYCLE COUNT/INVENTORY SPECIALIST- FALL RIVER, WI 1ST SHIFT Reporting to the Shipping Supervisor, the Cycle Counter is primarily responsible for inventory cycle counting and associated...

  • CO Refund Specialist

    5 months ago

    Middle River, United States Johns Hopkins University Full time

    Job Req ID: 114602 CO Refund Specialist We are seeking a who will be responsible for the processing of refunds and the resolution of credit balances. This position will analyze the EPIC billing system to assure accuracy of payment posting and third-party reimbursement. Credits will be appropriately investigated and processed following proper...

  • Cycle Counter/Inventory Control

    3 weeks ago

    Fall River, United States Metalcraft Full time

    Cycle Counter/Inventory Control - Fall River, WI 1st Shift Job Locations US-WI-Fall River Job ID 2024-3798 # of Openings 1 Category Manufacturing Type Regular Full-Time Overview CYCLE COUNT/INVENTORY SPECIALIST- FALL RIVER, WI 1ST SHIFT Reporting to the Shipping Supervisor, the Cycle...

  • Career Opportunities in Patient Access

    2 weeks ago

    Fall River, Massachusetts, United States Ensemble Health Partners Full time

    Discover Your Career in Patient AccessEnsemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.At Ensemble...

  • Sales Manager for CycleBar

    3 weeks ago

    River Forest, Illinois, United States CycleBar of United Fitness Full time

    Sales Manager Job DescriptionAt CycleBar, we're seeking a highly motivated and results-driven Sales Manager to join our team. As a Sales Manager, you will be responsible for driving sales and revenue growth within our studio. Your primary goal will be to meet studio sales goals, membership renewals, and ancillary service goals by pre-planning with strategic...

  • Sales Director

    3 weeks ago

    River Forest, Illinois, United States CycleBar of United Fitness Full time

    Job Summary:CycleBar of United Fitness is seeking a highly motivated and results-driven Sales Manager to join our team. As a Sales Manager, you will be responsible for driving sales and revenue growth within our studio, while delivering an exceptional customer experience.Key Responsibilities:Meet and exceed studio sales goals, membership renewals, and...

  • Customer Acquisition Specialist

    4 weeks ago

    Eagle River, Alaska, United States Idaho Leads, LLC Full time

    Job Title: Customer Acquisition SpecialistAbout the Role:Idaho Leads, LLC is seeking a highly motivated Customer Acquisition Specialist to join our team. As a key member of our team, you will be responsible for acquiring new customers and driving revenue growth through effective sales strategies. You will have the opportunity to work in a supportive...

  • Home Care Liaison

    1 month ago

    Fall River, Massachusetts, United States Associated Home Care Full time

    Job Title: Home Care Liaison - Growth Expansion SpecialistAssociated Home Care is seeking a highly motivated and results-driven Home Care Liaison to lead our private pay growth expansion efforts in MA and Seacoast NH. As a key member of our sales and marketing team, you will be responsible for driving revenue growth in assigned territory by acquiring new...

  • Consumer Loan Sales Specialist

    4 months ago

    Toms River, United States OneMain Financial Full time

    At OneMain, Consumer Loan Sales Specialists empower customers – listening to their needs and providing access to friendly, fast, and affordable financing for life’s expenses. Consumer Loan Sales Specialist will learn the lending and servicing business at OneMain allowing them to grow their career.    In the Role  Deliver results related to...

  • Program Management Specialist

    4 weeks ago

    Patuxent River, MD, United States Tekla Research Full time

    Job Summary:Tekla Research seeks a skilled Program Management Specialist to join our team. The ideal candidate will have a strong background in program management, with experience in developing, planning, analyzing, and executing projects across the full system life cycle.Key Responsibilities:Apply analytic techniques to evaluate program/project...

  • Sales Director

    4 weeks ago

    River Forest, Illinois, United States CycleBar of United Fitness Full time

    Job Title: Sales DirectorCycleBar is seeking a Sales Director to lead our sales team in Leawood. As a Sales Director, you will be responsible for driving sales and revenue growth within the studio. Your primary goal will be to meet studio sales goals, membership renewals, and ancillary service goals by pre-planning with strategic new customer outreach,...

  • Software Development Specialist

    1 month ago

    Patuxent River, United States V2X Full time

    Job SummaryV2X is seeking a skilled Software Development Specialist to support our customer at NAS Patuxent River, MD. The ideal candidate will have significant experience with hardware/software interface coding and software engineering functions such as requirement analysis and definition, configuration management, quality assurance, unit and system level...

  • Software Development Specialist

    4 weeks ago

    Patuxent River, United States V2X Full time

    Job Summary:V2X is seeking a skilled Software Development Specialist to support our customer at NAS Patuxent River, MD. As a key member of our team, you will be responsible for planning, integrating, and supporting the Next Generation Threat System (NGTS) into the Navy's LVC training environment.This position involves testing, managing, and data analysis of...

  • Telecommunications Sales Specialist

    1 month ago

    Hood River, Oregon, United States Blue Mountain Networks Full time

    Job SummaryWe are seeking a highly motivated and results-driven Telecommunications Sales Specialist to join our team at Blue Mountain Networks. As a key member of our sales team, you will be responsible for selling business telecommunications solutions to commercial customers, identifying and pursuing new business opportunities, and building strong...

  • Traveling Physical Therapist

    4 weeks ago

    Toms River, New Jersey, United States SkyBridge Healthcare Therapy Full time

    Job Details:Specialty: Physical TherapistDiscipline: TherapyEmployment Type: TravelSkyBridge Healthcare Therapy is seeking a skilled Physical Therapist to join their team for a travel job in New Jersey.Job Requirements:8 hours, days40 hours per weekBenefits:Mileage reimbursementMedical benefitsDental benefitsEmployee assistance programsVision benefitsHoliday...

  • Travel Physical Therapist Position

    4 weeks ago

    Toms River, New Jersey, United States SkyBridge Healthcare Therapy Full time

    Job Opportunity: SkyBridge Healthcare Therapy is seeking a skilled Physical Therapist for a travel job in a reputable healthcare facility.Job Description:Specialty: Physical TherapistDiscipline: TherapyEmployment Type: TravelSkyBridge Healthcare Therapy offers a competitive pay package based on 8 hour shifts and 40 hours per week, with a tax-free stipend...

  • Patient Access Representative Associate

    4 weeks ago

    River Falls, Wisconsin, United States Optum Full time

    Optum Job OpportunityAs a Patient Access Representative Associate at Optum, you will play a vital role in supporting the Allina Health account. Your primary responsibilities will include greeting and welcoming patients, collecting demographic and financial data, and entering information into an electronic medical record. You will also be responsible for...

  • Inventory Specialist

    3 weeks ago

    Fall River, Massachusetts, United States Metalcraft Full time

    Job SummaryThe Cycle Counter is a critical role within the Metalcraft team, responsible for ensuring the accuracy and efficiency of our inventory management processes. As a Cycle Counter, you will be responsible for conducting physical counts of inventoried materials, analyzing inventory data, and implementing process improvements to optimize our logistics...

  • Sales Manager

    6 months ago

    River Forest, United States CycleBar of United Fitness Full time

    CycleBar is seeking a Sales Manager for our state-of-the-art location in Leawood.  Our General Managers are passionate about fitness and delivering a superior experience.  They prioritize driving sales and revenue within the studio. Sales Managers are responsible for meeting studio sales goals, membership renewals and ancillary service goals by...