Revenue Cycle Specialist

District Partners
  • Gaithersburg, Maryland
    7 days ago

    Job Description

    Global in partnership with District Partners is looking for a motivated and solutions-oriented billing and follow-up specialist. You’ll be joining a fast-growing team with meaningful opportunities for professional growth and advancement within the company. This role also offers exposure to multiple areas of healthcare, providing the opportunity to broaden your knowledge and develop new skills within the industry. Global is a great fit for someone who is motivated, curious, and interested in building a long-term career in healthcare. 


    Global is a healthcare revenue cycle management company that has worked with hospitals for over 30 years. We provide customized solutions and innovative technology to improve financial performance, operational efficiency, and enhanced patient experience. We work with healthcare organizations across areas such as self-pay, insurance follow-up, patient engagement, and customer service. We are a growing organization with a strong focus on service, innovation, and long-term lasting partnerships. 


    What You'll Be Owning:

    • Manage assigned insurance receivables and proactively work outstanding balances toward payment or final resolution
    • Research unpaid, partially paid, and denied hospital claims to determine the cause of the outstanding balance
    • Communicate with commercial, Medicare, Medicaid, and managed care payers through phone, web portals, and other available channels
    • Analyze account history, remittance details, denial information, prior correspondence, and supporting documentation
    • Resolve issues involving denials, eligibility, authorization, coordination of benefits, medical necessity, timely filing, billing errors, coding concerns, and underpayments
    • Prepare and submit corrected claims, reconsiderations, appeals, or supporting documentation when appropriate
    • Identify accounts that require escalation or additional review from coding, billing, clinical, or other internal teams
    • Maintain thorough and accurate documentation of all research, payer interactions, actions taken, and required follow-up
    • Monitor assigned accounts through completion and ensure appropriate next steps are taken within expected timelines
    • Prioritize workload effectively while meeting established productivity, quality, and accuracy standards
    • Maintain confidentiality of patient and financial information in accordance with HIPAA and organizational requirements


    What You'll Bring to the Table:

    • At least 2 years of experience in healthcare insurance follow-up, hospital billing, accounts receivable, or revenue cycle operations
    • Experience with Epic is strongly preferred
    • Prior experience managing aged insurance receivables and outstanding claim balances
    • Strong knowledge of insurance follow-up, claim adjudication, denials, reimbursement, and payer processes
    • Experience researching and resolving unpaid or denied claims with insurance carriers
    • Ability to independently review account information and determine the appropriate course of action
    • Familiarity with EOBs, ERAs, claim status responses, payer correspondence, and denial information
    • Working knowledge of medical terminology and common healthcare billing concepts
    • Strong analytical, investigative, and problem-solving skills
    • Excellent attention to detail and documentation practices
    • Ability to work effectively in a high-volume environment and manage competing priorities
    • Strong verbal and written communication skills

    This role is best suited for someone who understands how to work aged hospital A/R, investigate payment delays and denials, communicate effectively with insurance carriers, and determine the appropriate action needed to move an account forward. The successful candidate will be comfortable reviewing complex account histories, identifying the underlying issue, and following through until the balance is appropriately resolved.

    Numbers & Facts

    LocationGaithersburg, Maryland

    Skills

    • Accounts Receivableunmatched
    • Accounts Receivable Managementunmatched
    • Adjudicationunmatched
    • Analysis Skillsunmatched
    • Billingunmatched
    • Code Reviewsunmatched
    • Communication Skillsunmatched
    • Customer Escalationsunmatched
    • Customer Support/Serviceunmatched
    • Detail Orientedunmatched
    • Documentationunmatched
    • Establish Prioritiesunmatched
    • Financial Managementunmatched
    • HIPAA (Health Insurance Portability and Accountability Act)unmatched
    • Health Insuranceunmatched
    • Healthcareunmatched
    • Hospitalunmatched
    • Identify Issuesunmatched
    • Insuranceunmatched
    • Insurance Claimsunmatched
    • International Healthunmatched
    • Internet Portalunmatched
    • Long-Term Careunmatched
    • Managed Careunmatched
    • Medicaidunmatched
    • Medical Billingunmatched
    • Medical Codingunmatched
    • Medical Recordsunmatched
    • Medical Terminologyunmatched
    • Medicareunmatched
    • Operational Strategyunmatched
    • Patient Care Denialsunmatched
    • Patient Confidentialityunmatched
    • Patient Follow-upunmatched
    • Presentation/Verbal Skillsunmatched
    • Problem Solving Skillsunmatched
    • Reimbursementunmatched
    • Revenue Managementunmatched
    • Time Managementunmatched
    • Writing Skillsunmatched

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