Revenue Cycle Account Specialist

IN SUMMARY...

The Revenue Cycle Account Specialist is responsible for executing day-to-day revenue cycle functions for assigned client accounts, ensuring accurate, timely, and compliant processing across all billing activities. This role serves as a primary point of contact for clients while managing tasks such as charge entry, claims submission, payment posting, denial follow-up, and accounts receivable resolution.

The Revenue Cycle Account Specialist supports the financial health of client accounts by maintaining workflow efficiency, resolving routine issues, and adhering to established billing guidelines and performance standards. This position requires strong attention to detail, effective communication, and a solid understanding of revenue cycle processes to ensure high-quality service and client satisfaction.

WHAT YOU WILL DO...

• Function as primary liaison between  RCM and client.

• Build team relationships with physicians, practice administrators and office staff. 

• Manage assigned accounts to ensure timely and accurate completion of revenue cycle tasks in alignment with established benchmarks and KPIs. As it relates, but not limited to the following tasks:

• • All charge processes

  • ERA and paper payments are posted timely and accurately.

  • File claims to insurance companies electronically or paper as required.   

  • Monitor clearinghouse reports for claim confirmation and acceptance.   

  • Work all rejected claims received via the clearinghouse.   

  • Research and resolve denied and outstanding claims, identifying trends and escalating issues as appropriate.

  • Clean up of outstanding A/R, and maintain to meet division benchmarks

  • Generate patient statements.   

  • Process patient and insurance refunds.   

  • Complete month end processing and reporting.   

• Identify and escalate complex issues or trends to leadership for further review and resolution.

• Follow and maintain client-specific workflows and billing guidelines to ensure consistency and compliance.

• Identify and resolve issues in a timely manner to prevent escalation to management.

• Manage and resolve patient, insurance, and client inquiries promptly while maintaining a high level of customer service.   

• Assist with billing system maintenance, as required.   

• Follow company policies, procedures and protocol, report compliance issues.   

• Adhere to all HIPAA regulations by keeping all patient information confidential and protected.   

• Participate in educational opportunities.   

• Follow client specific workflow schedules.   

• Perform duties in a timely manner as required by clients and company.       

• Other duties, as assigned.   

BACKGROUND AND SKILLS YOU WILL BRING...

• High School diploma or GED   

• 3-5 years' experience in medical billing/collection practices and customer service   

• Candidate should have the following knowledge for the Fertility role:

• • Case Rate Management, Medical Record Management, Cycle Management/Treatment Mapping, Fertility Coding, Global/Bundled Services Management, Genetic Testing Management, Embryology Billing, ASC/Facility Billing, Fertility AR Follow Up

• Candidate should have the following knowledge for the Rural Health Center role:

• • Medicare RHC Bundling Rules, UB04/Institutional Billing, Medicare Advantage Bundling Rules, Medicaid Bundling Rules, A/R RHC, AIR Rate & RHC Reimbursement, RHC Qualifying Visits, RHC Modifiers, RHC Provider Eligibility, RHC Lab Billing,

• Computer data entry   

• Understanding of payment application processes   

• Working knowledge of Microsoft Office and Google Workspace  

• Ability to follow instruction and adhere to company policies and procedures   

• Must be a team player and willing to learn and take on new responsibilities   

• Problem solving and analytical skills   

• Strong oral and written communication skills   

• Familiarity with insurance companies (medical) coverage and benefits   

• Intermediate to advanced medical billing knowledge   

• Accounting knowledge   

• Ability to represent the Company  in a professional manner at all times   

SUCCESS LOOKS LIKE...

• Being aggressive and taking initiative; we trust you to move the needle forward

• Doing the job; outcomes are just as important as strategy

• Being adaptable and amenable to meet the changes of a dynamic and evolving industry

• Demonstrating humility; partnership and collaboration is who we are and how we operate

• Tapping into your innovative side; conventional is not always correct

HOW WE INVEST IN YOU...

• Competitive and comprehensive benefits: Coverage options to support the whole person, including full medical, dental, vision, and life insurance

• • Generous employer sponsored subsidy towards employee's medical insurance premiums

  • Azalea Health covers 100% of the premiums for Life AD&D and Long-Term Disability for all eligible full-time employees

• Balance and flexibility: Simple Paid Time Off (PTO) options. You earn your time, use it as you choose.

• Economic opportunity: Competitive total rewards package that offers competitive pay and advancement opportunities

Azalea Health's EEO Statement

Azalea Health is an Equal Opportunity Employer committed to creating a diverse and inclusive workforce where our employees excel based on merit, qualifications, knowledge, ability, and job performance. We embrace and encourage our employees' differences in age, color, disability, ethnicity, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socioeconomic status, veteran status, and any other characteristics protected by federal, state, and local laws that make our employees unique.