Revenue Cycle Specialist

Responsibilities

• Perform core revenue-cycle functions, including billing, claims filing, data entry, charge entry, insurance follow-up, denial management, payment posting, billing-record review, and customer service
• Bill and submit Rural Health Clinic claims to insurance carriers daily
• Research, correct, resubmit, and appeal front-end claim edits, clearinghouse returns, rejected or denied claims, and claims receiving no response
• Review accounts receivable and prioritize follow-up based on aging, payer requirements, and reimbursement opportunity
• Reconcile explanations of benefits and post payments, with the goal of ending each day at a zero balance
• Maintain accurate patient, provider, practice, fee, and charge information in the billing system
• Meet with the Billing Team Supervisor to identify and resolve reimbursement issues and billing obstacles
• Perform other duties as assigned

Required qualifications

• High school diploma or GED
• At least two years of medical claims billing experience
• Experience submitting claims and processing client invoice billing
• Ability to abstract clinical information from medical records, charts, and other documents
• Ability to assign appropriate ICD-10 and CPT/HCPCS codes according to established procedures
• Knowledge of insurance billing guidelines, including Medicare, Medicaid, and other payers
• Knowledge of payer updates, bundling and unbundling, medical necessity, coding requirements, and medical terminology
• Proficiency with general computer applications, Microsoft Word and Excel, and EMR or EHR systems

Preferred qualifications

• Associate degree or higher
• One or more relevant credentials, including CCS, CCSP, CPC, CPC-P, RHIA, COC, or CPCH

Position details

• Location: Flowood, Mississippi
• Work arrangement: On-site