Specialist, Revenue Cycle

4 days ago

Durham, North Carolina, United States FastMed Full time

Position Summary 

The Revenue Cycle Specialist will be responsible for the day-to-day operation in the following areas: posting, billing, claims resolution, A/R follow-up, credit balance or EDI billing. Under the direction of the Manager the Specialist will be responsible for handling all functions related to the designated area and any other duties assigned by management. 

Duties and Responsibilities 

  • Responsible for claim submissions to both government and commercial payors in accordance with all insurance regulations and requirements.
  • Provide all necessary documentation required by payors to resolve claim issues or denials, including medical records, prior authorizations, audits, etc.
  • Analyze and research all denials and over or under payments.
  • Ensure all payor correspondence is reviewed and followed up on immediately.
  • Timely posting of all cash receipts and reconcile statements daily.
  • Provide exceptional customer service and communication to patients and resolve any accounts receivable requests in a timely and accurate manner.
  • Communicate any issues to the Revenue Cycle Manager
  • Please Note: The list of responsibilities detailed above is not a comprehensive list, nor is it intended to be a list of all responsibilities and duties of the RCM specialist. 

Experience, Skills and Education 

  • 2+ years of relevant billing experience within a healthcare facility or healthcare insurance company.
  • Deep understanding of medical billing rules and supporting documentation requirements for both government and commercial payors.
  • Knowledge of ICD-10 and HCPC coding, modifiers, and other medical terminology.
  • Proficient with Microsoft Office, specifically Excel, Outlook, and Word.
  • Epic or NextGen experience a plus, but not a requirement.
  • High School diploma required.

While performing the essential functions of the job the employee may work remotely dependent upon the company and/or department's policies.  

FastMed reserves the right to revise and amend job descriptions at any time.

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