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Revenue Cycle Specialist

1 month ago

Altoona, Wisconsin, United States Surgery Partners Full time
Job Summary:

A Revenue Cycle Specialist is needed to manage patient accounts, communicate with payers, and resolve account balances. This role requires strong knowledge of insurance carrier policies, clearinghouse edits, and clinical requirements to expedite cash flow.

Key Responsibilities:
  • Research and resolve account balances
  • Follow up on claims not paid, underpaid, or denied
  • Maintain compliance with company and government reimbursement policies
  • Issue electronic and paper billing to ensure timely resolution of claims
  • Perform insurance verification functions
  • Identify patient out-of-pocket responsibility
  • Coordinate pre-authorization, pre-certification, and referral processes
  • Contact patients for financial arrangements
  • Ensure accurate billing and collection duties
  • Perform billing and collection functions within the Hospital computer system
  • Prepare daily bank deposits
  • Research and resolve customer inquiries
  • Analyze credit balances and process refunds
  • Work with internal and external customers to maintain accurate records

Qualifications:
  • Medical background working in a healthcare environment required
  • Experience working in a hospital preferred
  • Knowledge of medical terminology, coding, and claims processing
  • Knowledge of medical insurance, Medicare, and Medicaid
  • Exceptional human relations, communication, and coordination skills
  • Detail-oriented and accurate
  • Effective decision-making skills
  • Eligibility for employment in the U.S.
  • Ability to relate and work effectively with others

Benefits:
  • Comprehensive health, dental, and vision insurance
  • Health Savings Account with employer contribution
  • Free meals
  • PTO
  • 401(k) retirement plan with 4% company match
  • Tuition reimbursement
  • Wellness reimbursement