Revenue Cycle Specialist

Overview

The Revenue Cycle Specialist's primary responsibility is the assurance of Medicaid policies & procedures across all Arrow services. These processes will inform and improve practices that have a direct impact on services to children, families, and compliance. This position is responsible for accurately billing and collecting on Medicaid claims, working denials, and reporting denial trends in internal stakeholders.

Benefits Include

• Medical, dental, vision, and supplemental insurance options, including HSA match for qualifying contributions.
• Parental Paid Leave
• Retirement savings plan with company match.
• Paid time off and holiday pay.
• Mileage reimbursement.
• Tuition reimbursement available.
• Company sponsored learning and development

Responsibilities

Other duties may be assigned as necessary.

• Confirming patient insurance eligibility, correctly assigning medical codes (CPT/ICD-10), and preparing and submitting claims to third-party payers.
• Communicate with internal stakeholders to address billing questions and concerns.
• Review and submit insurance claims accurately, ensuring compliance with payer requirements and coding standards.
• Track and follow up on unpaid claims, working with payers to resolve denials and rejections within deadlines.
• Prepare and submit letters of appeal for denied claims, ensuring that all required documentation is included.
• Monitoring aging reports, tracking outstanding balances, and minimizing payment delay.
• Maintain up-to-date knowledge of industry regulations, payer policies, and coding changes.
• Ensure compliance with all state and federal regulations, including HIPAA.
• Perform all duties within contract, state and federal regulations, Arrow policy, NCASES and COA standards.
• May be required to drive vehicles, be insurable with our auto insurance provider, and complete company vehicle training.
• Occasional travel may be required.

Qualifications

Bachelor's degree in human services, business, finance, statistics, or related field required, master's degree preferred. The ideal candidate will have child welfare experience with a minimum of five (5) years relevant experience in revenue cycle operations, including billing, coding, reimbursement process, data analysis and risk management.