Revenue Cycle Specialist

REVENUE CYCLE SPECIALIST

FLSA: NON-EXEMPT

Duties/Responsibilities:

• Generate and process accurate invoices for services provided.
• Ensure all billing information is complete and accurate, including service codes, charges, and patient information.
• Review and verify revenue cycle data for errors or inconsistencies and correct them as needed.
• Monitor accounts receivable and track outstanding payments to ensure timely collection.
• Reconcile payments and resolve any discrepancies in accounts.
• Coordinate with patients or insurance companies to resolve billing issues and follow up on unpaid invoices.
• Handle billing for Medicare, Medicaid, and private insurance, including submitting claims and verifying insurance eligibility.
• Ensure compliance with insurance reimbursement regulations and follow up on denied, appeals and delayed claims.
• Review any claims aged over 90 days.
• Prepare and submit claims with proper coding (CPT-4, ICD-10) and documentation as required.
• Maintain accurate financial records, including invoices, payment histories, and billing reports.
• Scan and maintain electronic images of paper remittance vouchers.
• Assist in audits by providing necessary financial documentation and reports.
• Ensure billing practices comply with company policies, government regulations, and industry standards.
• Ensure revenue cycle practices comply with SCHC policies, government regulations, and industry standards.
• Communicate with patients to clarify billing information, resolve discrepancies, and update account details.
• Provide customer support regarding billing questions and payment options.
• Work closely with internal teams such as finance, customer service, and management to address billing-related concerns.
• Prepare regular reports on revenue cycle performance, outstanding accounts, and collection efforts.
• Analyze billing data to identify trends, inefficiencies, and areas for improvement.
• Recommend and implement process improvements to enhance the accuracy and efficiency of revenue cycle operations.
• Use revenue cycle software and electronic medical record (EMR) systems to process and manage revenue cycle
• Perform additional tasks as needed to support the centers.

Required Skills/Abilities:

• Excellent verbal and written communication skills.
• Excellent interpersonal and customer service skills.
• Excellent organizational skills and attention to detail.
• Excellent time management skills with a proven ability to meet deadlines.
• Strong analytical and problem-solving skills.
• Collaborate with IT and finance teams to troubleshoot issues with billing systems.
• Stay updated on software updates and best practices to optimize billing processes.
• Ability to use office equipment, including computers, copy machines, fax machines, telephones, calculators, and more.
• Ability to prioritize tasks and to delegate them when appropriate.
• Ability to function well in a high-paced and at times stressful environment.
• Proficient with Microsoft Office Suite, Electronic Medical Records (EMR) and related software.

Education and Experience:

• High School diploma or equivalent
• At least three years related experience required.
• Proficiency in billing software, EMR systems, and Microsoft Office (Excel, Word, Outlook and similar software)
• Familiarity with Medicare, Medicaid, private insurance reimbursement, and coding systems.

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.
• Must be able to travel to various center locations as required.