Revenue Cycle Specialist
Core
Ensure accurate billing, timely payment processing, and support for client organizations by managing patient accounts and insurance claims.
Role type
Revenue Cycle Specialist
Builds
Accurate insurance claims and timely cash receipts for human services agencies
Domain
Healthcare billing and revenue cycle management
Deliverable
production ML models | product features | dashboards & analysis | research | client delivery | infrastructure | physical/clinical work
Required skills
Insurance eligibility verification, prior authorization tracking, accounts receivable management, claim submission and follow-up, cash reconciliation, HIPAA compliance
Preferred skills
Associate degree, experience with electronic reimbursement systems, proficiency in Microsoft Excel and EHRs
Technologies
Microsoft Excel, EHRs, practice management software, electronic reimbursement systems
Responsibilities
Post payments, adjustments, and denials to patient accounts; reconcile daily and monthly cash receipts; verify insurance eligibility and benefits; obtain and track prior authorizations; prepare and submit insurance claims; monitor outstanding claims and follow up on unpaid accounts; partner with Billing, Collections, Intake, and client teams to resolve reimbursement issues; maintain compliance with HIPAA and organizational policies
Seniority
Mid-level, hands-on IC