Revenue Cycle Specialist | BAR - Medicare

Overview: Responsibilities:

Key Responsibilities

• Bills professional claims in accordance with federal regulations, managed care requirements, and payer compliance guidelines.
• Researches and resolves patient account issues to ensure accurate billing and reimbursement.
• Verifies insurance eligibility, benefits, and coverage information.
• Identifies reimbursement issues, payment variances, and revenue opportunities.
• Processes account credits and issues refunds in accordance with organizational policies.
• Follows up on and resolves denied claims to maximize reimbursement and reduce accounts receivable.
• Maintains compliance with revenue cycle policies, billing regulations, and payer requirements.

Qualifications:

Education

• High school diploma or equivalent required.
• Associate's degree may substitute for the required work experience.

Minimum Qualifications

• Minimum of six (6) months of healthcare billing, collections, revenue cycle, or financial experience or one (1) year of experience in a business environment involving finance, accounting, insurance, or collections.
• Strong communication, organizational, problem-solving, and customer service skills.
• Ability to discuss financial matters and collect payments from patients and payers in a professional manner.
• Demonstrated ability to multitask, prioritize competing responsibilities, and work effectively in a team environment.

Preferred Qualifications

• Working knowledge of CPT and ICD-10 coding.
• Knowledge of federal regulations, managed care rules, and healthcare billing compliance requirements.
• Experience using the Epic electronic health record (EHR) system.

Licensure/Certification

• No licensure or certification required.