Senior Revenue Cycle Specialist

23 hours ago

Nashville, Tennessee, United States Talently Full time

Job Title:
Senior Revenue Cycle Specialist

Location:
On Site - Nashville, Tennessee, United States

Salary:
$55,000-$65,000

Skills:
Revenue Cycle Management (RCM), AR Management, Denials Resolution, Medical Coding (ICD9/10, CPT, HCPCS), Process Optimization

About the Hospitals and Health Care Company / The Opportunity:

Join an innovative leader in the hospitals and health care sector dedicated to optimizing financial processes and enhancing patient care delivery. This role offers a unique opportunity for a data-driven professional to drive revenue cycle improvements and ensure financial integrity within a dynamic healthcare environment. As a Senior Revenue Cycle Specialist, you will play a pivotal role in streamlining complex financial workflows, supporting compliance, and maximizing revenue outcomes for the organization and its patients.

Responsibilities:

  • Manage accounts receivable (AR) processes, ensuring timely and accurate collections.
  • Collaborate with Revenue Cycle Business and Financial Analysts on claim resolution and oversight.
  • Prepare, review, and validate complex medical records for accuracy and completeness.
  • Interpret payer correspondence and determine the appropriate next action for claims.
  • Submit appeals and reconsideration requests, offering process improvement suggestions as needed.
  • Update and review line-item receipt postings and resolve posting discrepancies.
  • Address assigned hold codes, including denials related to eligibility, addresses, or other issues.
  • Track and obtain client and provider documentation for comprehensive recordkeeping.
  • Ensure all claims and appeals documentation are accurately uploaded into the relevant systems.
  • Verify insurance coverage and prior authorization requirements to support claims adjudication.
  • Collaborate across Billing, Coding, Patient Access, and Cash Receipts teams for cohesive workflow management.
  • Mentor and train new team members, and lead projects focused on process optimization.

Must-Have Skills:

  • High school diploma or GED required (Associate's/Bachelor's degree in Business, Finance, or related discipline preferred).
  • Minimum 6 years of revenue cycle experience in a hospital, laboratory, ambulatory surgery center, or large medical practice (3 years specific to denials management required); or 3 years of denials management with a Bachelor's degree.
  • Proven expertise in AR management, denials resolution, and claims processing.
  • In-depth knowledge of ICD9, ICD10, CPT, and HCPCS coding.
  • Strong working knowledge of Microsoft Office Suite, especially Excel and Outlook.
  • Exceptional accuracy, attention to detail, and the ability to work effectively in a fast-paced, team-oriented environment.
  • Demonstrated ability to follow Standard Operating Procedures (SOPs) and take direction clearly.
  • Effective communication skills and experience mentoring others or leading initiatives.

Nice-to-Have Skills:

  • Associate's or Bachelor's degree in a related field.
  • Experience leading large-scale process optimization projects within healthcare finance or RCM.
  • Familiarity with OnBase or similar medical documentation management systems.
  • Knowledge of payer-specific policies and prior authorization procedures.
  • Ability to suggest and implement enhancements in operational SOPs.
  • Experience training or onboarding new team members in a healthcare setting.

  • Revenue Cycle Specialist

    2 weeks ago

    Nashville, Tennessee, United States Mental Health Cooperative Full time $45,000 - $70,000 per year

    Ranked one of Tennessee's top places to work, MHC is a rare and special place where outstanding company culture is intentional. Where clients and associates are treated the same, as equals.Mental Health Cooperative, Inc. (MHC) was formed in 1993 to serve individuals with severe and persistent mental illness.  Since then, we have expanded our services to...

  • Revenue Cycle Specialist II

    2 weeks ago

    Nashville, Tennessee, United States Aegis Sciences Corp Full time $65,000 - $85,000 per year

    The Revenue Cycle Specialist II is responsible for analyzing and optimizing the financial processes within a healthcare organization, including patient registration, billing, coding, claims submission, and collections, by identifying areas for improvement, monitoring key performance indicators (KPIs), and implementing strategies to maximize revenue while...

  • Revenue Cycle Systems Specialist

    7 days ago

    Nashville, Tennessee, United States Pennant Full time

    We are building a World Class Service Center and invite you to join a team of people who are committed to a core objective of supporting life changing service and providing professional expertise to the operations and leaders we support.About The CompanyPennant Services is one of the most dynamic and progressive companies in the rapidly expanding senior...

  • Senior Director Of Revenue Cycle

    23 hours ago

    Nashville, Tennessee, United States BrightSpring Health Services Full time

    Our CompanyBrightSpring Health ServicesOverviewThe Sr. Director is responsible for management of the Revenue Cycle organization and process to ensure the timely and accurate billing of services provided and maximizing collections on all billings for the rehabilitation business unit. The Sr Director's responsibilities include identifying reimbursement issues,...

  • Revenue Cycle Specialist II

    4 days ago

    Nashville, Tennessee, United States Matthew Walker Comprehensive Health Center Full time

    SUMMARY: Reporting to the Revenue Cycle Manager, this task-oriented individual is responsible for ensuring the organization meets its desired patient revenue goals by maintaining weekly claims processing, monitoring aging reports, monitoring unprocessed/denied claims and collections of private pay, insurance and fee for service claims.ESSENTIAL DUTIES AND...

  • Sr. Revenue Cycle Relationship Manager

    2 weeks ago

    Nashville, Tennessee, United States Qualifacts Full time $80,000 - $120,000 per year

    Job DescriptionQualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve....

  • Director of Revenue Cycle Management

    2 weeks ago

    Nashville, Tennessee, United States Pennant Full time $120,000 - $180,000 per year

    We are seeking a strategic and experiencedDirector of Revenue Cycle Management (RCM)to lead and optimize our end-to-end revenue operations. This role oversees five specialized teams—Intake, Insurance Authorization, Medical Records, Billing, and Collections—and is responsible for ensuring seamless integration, compliance, and financial performance across...

  • Revenue Cycle Operations Manager

    5 days ago

    Nashville, Tennessee, United States The Wilshire Group Full time

    Wilshire hires only the brightest and most experienced professionals in the healthcare revenue cycle management industry. Wilshire will take the time to get know you and your employment history. We will then place you in a role that will lead to a path of career success.About The Wilshire GroupThe Wilshire Group, a renowned boutique consulting firm in Los...

  • Consultant - Revenue Cycle

    7 days ago

    Nashville, Tennessee, United States RubinBrown Full time

    RubinBrown is one of the nation's leading accounting and professional consulting firms with a commitment to building personal relationships and delivering totally satisfied clients. The RubinBrown name and reputation are synonymous with experience, integrity and value. RubinBrown has revenue of approximately $240 million with 1,000+ team members across...

  • Front-End Revenue Cycle Lead-Dental

    7 days ago

    Nashville, Tennessee, United States The Wilshire Group Full time

    Wilshire hires only the brightest and most experienced professionals in the healthcare revenue cycle management industry. Wilshire will take the time to get know you and your employment history. We will then place you in a role that will lead to a path of career success.About The Wilshire GroupThe Wilshire Group, a renowned boutique consulting firm in Los...