Revenue Cycle Specialist (REMOTE)

JOB SUMMARY

The Revenue Cycle Specialist will be responsible for overseeing the entire revenue cycle process for company owned stores, including overseeing billing, collections, and accounts receivable. The Revenue Cycle Specialist will oversee resolution for all billing related issues for all company owned stores. In conjunction with operations, reviews and enhances insurance verification, coding review, billing, collection, and payment posting processes for efficiency and best practices; ensure systems are fully functional and maximized and recommend new processes to improve current workflow.

MAJOR DUTIES AND RESPONSIBILITIES

• Develops and implement policies and procedures related to revenue cycle management to ensure efficient and effective operations.
• Analyzes contracts with insurance providers and negotiate rates to ensure the company is receiving the best possible reimbursement
• Monitors billing and coding practices to ensure compliance with state and federal regulations
• Works collaboratively with the operational and clinical teams to ensure accurate documentation of services provided.
• Develops and maintains relationships with insurance providers to ensure prompt payment and accurate reimbursement
• Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers
• Maintain appropriate internal controls for the safeguarding of cash.
• Serves as the subject-matter expert on regulatory, compliance, and legal requirements associated with medical billing. Follows and monitors compliance.
• Ensures compliance with relevant regulations, standards, and directives from regulatory agencies and third-party payers
• Ensures compliance with relevant federal, state, and payor-specific billing requirements.
• Manages contractual relationships with customers
• Performs other duties as assigned

REQUIRED QUALIFICATIONS

EDUCATION

High School Diploma

SKILLS/ABILITIES

2 years of experience in revenue cycle management, preferably in a home health or healthcare setting

• Strong knowledge of healthcare regulations and insurance policies related to revenue cycle management
• Ability to manage patient billing related complaints.
• Ability to continuously improve the functions Revenue Cycle team.
• Proven experience in healthcare billing.
• Sound knowledge of health insurance providers.
• Proficient in all Microsoft Office applications including some formula proficiency in MS Excel.
• Excellent customer service skills.
• Ability to work in a fast-paced environment.
• Excellent verbal and written communication 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.
• Ability to read, write, speak, and understand English
• Ability to maintain confidentiality of information
• Ability to make decisions and solve problems while working under pressure
• Ability to prioritize and organize effectively
• Ability to show judgment and initiative and to accomplish job duties in a timely manner
• Ability to work independently

WORKING CONDITIONS

This role is a remote role depending upon location.

Travel requirement: 5% as needed to support the successful operation of the business.

The contents of this Job Description have been discussed with me and I have received a copy. I understand that this document is general in nature and responsibilities required may be amended from time to time. The signing of this Job Description acknowledges a complete understanding of the responsibilities of this position. An item not understood should be clarified before signing to ensure that I understand what is expected.