What are the responsibilities and job description for the Revenue Cycle Associate position at Pathway Healthcare?
Position Role: We are seeking a Revenue Cycle Associate to join our team in a hybrid remote capacity. This role is responsible for key revenue cycle functions that directly impact cash flow, including electronic and hard-copy claims submission, third-party billing, and ensuring all documentation is accurate and timely.
Key Responsibilities
Claims Processing & Follow-Up:
- Perform accounts receivable (AR) follow-up for claims under 60 days.
- Understand detailed billing requirements, denial reason codes, and insurance follow-up practices.
- Resubmit claims with necessary corrections and ensure all claim requirements are met.
- Organize open accounts by denial type or payer for efficient resolution.
- Resolve work queues per priority guidelines and management directives.
Denial Management & Payment Processing:
- Review Explanation of Benefits (EOBs) and remittance advices to confirm correct payments and adjustments.
- Communicate effectively via phone and written correspondence to explain outstanding balances, denials, and underpayments.
- Identify trends in denials or reimbursement and escalate concerns accordingly.
- Recognize when additional assistance is required and escalate issues through appropriate channels.
- Keep management informed of billing requirement changes, rejection codes, and denial codes affecting claim processing.
Compliance & Documentation:
- Accurately document patient accounts in the billing system.
- Maintain strict confidentiality of medical records and adhere to all HIPAA regulations.
- Ensure integrity of account documentation in compliance with company policies.
- Stay up to date on internal, industry, and government regulations relevant to assigned tasks.
Communication & Collaboration:
- Work with supervisors and staff to navigate insurance carrier contractual and regulatory requirements.
- Assist with complex or escalated issues as needed.
- Identify and report potential concerns and trends in follow-up functions.
- Meet quality assurance and productivity standards for accurate and timely denial resolution.
Qualifications & Skills
✔ Minimum 2 years of experience in revenue cycle management or medical billing (REQUIRED)
✔ Strong understanding of insurance billing, denials, and payer reimbursement practices
✔ Excellent organizational, problem-solving, and multitasking skills
✔ Ability to work independently while collaborating effectively with teams
✔ Strong computer skills, including proficiency in Microsoft Excel, Word, and Email
✔ Experience handling confidential patient information in compliance with HIPAA regulations
✔ Ability to work under pressure in a fast-paced environment
Compensation and Benefits
- Competitive Pay: $20 - $23 per hour depending on experience
- Health Benefits: Comprehensive health benefits, including free Teladoc services for full-time employees
- Paid Time Off: Generous PTO and holiday schedule
- Professional Growth: Opportunities for career advancement and continuous learning
Ready to make an impact? Send us your resume today!
Job Type: Full-time
Pay: $20.00 - $23.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Life insurance
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
- No weekends
Work Location: In person
Salary : $20 - $23
