Hospital Revenue Cycle Specialist

2 days ago


Austin, Texas, United States eMDs Full time
Job Summary

The Hospital Collections Specialist plays a critical role in the Revenue Cycle Management department, responsible for following up on unpaid insurance claims. This position requires a strong understanding of healthcare code sets, clean claim practices, and the adjudication process.

Key Responsibilities
  • Working with aged accounts to ensure timely resolution
  • Conducting complex denial research to identify and resolve claim issues
  • Participating in client meetings to discuss claim status and resolution
  • Providing exceptional customer service to patients, clients, and insurance carriers
  • Maintaining confidentiality and adhering to HIPAA guidelines
  • Staying up-to-date on code changes, reimbursement guidelines, and coverage policies
Requirements
  • Working knowledge of healthcare code sets, clean claim practices, and the adjudication process
  • Ability to research and follow claims appeal guidelines and processes
  • Understanding of the complete healthcare revenue cycle, provider contracts, and credentialing
  • Proficient in Microsoft Outlook, Word, Excel, and electronic health records/practice management systems
  • Organized and detail-oriented with excellent communication skills
Education and Experience

Previous experience in a healthcare billing capacity is required, with previous experience in hospital-based follow-up and electronic health records/practice management systems desirable.

Language Skills

English is the primary language required for this position.

Certificates/Licenses/Registrations

Coding certificates such as CPC, CCS-P, CCS, etc. are desirable but not required.

Physical Demands/Work Environment

This position requires the ability to lift 50lbs and work in a fast-paced environment.



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