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Revenue Cycle Specialist- Canonsburg, PA

Preferred Primary Care Physicians, Inc.
Canonsburg, PA Full Time
POSTED ON 1/17/2025
AVAILABLE BEFORE 3/16/2025

Preferred Primary Care Physicians (PPCP) is currently recruiting for an onsite full-time Revenue Cycle Specialist to work out of PPCP's Central Administrative office located in Canonsburg, PA. The ideal candidate will have a minimum of 3 years of charge entry/claims/billing/collections experience. Schedule is Monday-Friday day. Ability to work remotely 3 days per week after completing 90 days in the office.

General Purpose of the Revenue Cycle Specialist Position:

The Revenue Cycle Specialist is responsible for all fiscal functions necessary to ensure the Revenue Cycle process for PPCP is submitted to insurance timely, posting of payments accurately, and manage the denials and Accounts Receivable. The Revenue Cycle Specialist is well versed and crossed trained in all areas of the revenue cycle and accustomed to working in a high-volume environment.

Account Representatives are responsible to: ensure professional charges and claims are submitted accurately and timely; communicating with insurance companies, communicating with office locations for appropriate medical record documentation, recommending adjustments according to PPCP policies, reviewing the posting and balancing of payment/denial and adjustment transactions necessary for closing accounts, identify and assign appropriate status codes, and review high dollar accounts on a regular basis. The Revenue Cycle Specialist is expected to identify recurring problems and procedural deficiencies that need to be reported to management.

Essential Functions:

    • Understand Primary Care and Internal Medicine CPT coding.
    • Ability to multi-task
    • Identify root cause issues and demonstrate the ability to recommend corrective action steps to eliminate future occurrences.
    • Assist in claim appeal process and/or perform follow-up in accordance with Revenue Cycle policies and procedures.
    • Understand third party billing and collection guidelines.
    • Read and distribute payer newsletters and relevant communication.
    • Appropriately post payments.
    • Interpret Explanation of Benefits and follow up on any denials.
    • Demonstrate knowledge of the current functionality of the patient accounting systems.
    • Identify issues and submit corrective action recommendations.
    • Ability to work independently with minimal supervision.
    • Meet quality assurance benchmark standards and maintain productivity levels as defined by management.
    • Other duties and responsibilities as assigned by leadership.

Education/Qualifications:

  • High school diploma or equivalent and three to five years of charge entry/claims/billing/collections experience.

About Us:

At Preferred Primary Care Physicians, preferred health care is simply our standard. Our practice was established in 1995 when a group of dedicated physicians in the South Hills came together for one common purpose: to provide the highest quality care to their patients. Their ingenuity and expertise laid the foundation for our independently owned practice, which now operates out of more than 20 locations in the greater Pittsburgh area. Our elevated level of service is supported by our team-based approach, comprehensive clinical programs, and state-of-the-art outpatient centers. From providing general primary care to managing chronic conditions, we give all of our patients the preferential treatment they deserve.

Come join the team and enjoy a very competitive employee benefit package including medical, dental, vision, company paid life insurance, and 401k with competitive match.

Please visit our website www.ppcp.org for more info about our company.

EOE

Salary : $16 - $20

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