Revenue Cycle Specialist
2 weeks ago
Position Summary
The Revenue Cycle Specialist serves as a key resource for all aspects of the revenue cycle. This role is tasked with collaborating across departments to enhance processes and workflows, ensuring the effective and precise handling of claims.
Key Responsibilities
- Maintains current knowledge of medical billing regulations and payer-specific requirements to ensure compliance in claim submissions.
- Facilitates regular team discussions to share updates, resolve issues, and align with organizational objectives.
- Engages with patients, staff, and external partners to address inquiries and provide necessary information.
- Reviews monthly aged accounts receivable reports to ensure compliance with organizational targets.
- Develops educational resources to promote continuous staff development.
- Delivers training to staff on best practices in documentation, coding, and billing to reduce denial rates.
- Participates in payer meetings to discuss patient-related issues, benefits, or claims.
- Analyzes data to uncover trends, opportunities, and challenges within the revenue cycle.
- Establishes guidelines for timely and accurate claim submissions to minimize denial risks.
- Reports findings and suggestions to management and relevant stakeholders.
- Performs additional duties as required.
Minimum Qualifications
- Education
- Associate Degree in Healthcare Business Services or a related discipline is required.
- Licensure/Certification
- Preferred advanced training or certification in medical billing, coding, or insurance.
- Experience
- At least five years of experience in a medical billing capacity is required, or equivalent educational background.
Required Competencies
- Knowledge
- Familiarity with medical and insurance terminology.
- Basic understanding of CPT, HCPCS, and ICD-10 coding.
- Skills
- Strong interpersonal, communication, and listening skills to interact effectively with patients and staff.
- Proficient in using Electronic Medical Record (EMR) systems, Practice Management software, and Microsoft Office Suite.
- Exhibits professionalism and respect in all communications.
- High accuracy and efficiency in entering patient financial and related data.
- Abilities
- Ability to maintain confidentiality of financial and health information.
- Capable of thriving in a fast-paced, multi-tasking environment while being a collaborative team member.
- Skilled in gathering and preparing information accurately and efficiently.
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