What are the responsibilities and job description for the Revenue Cycle Specialist I position at The Staff Pad?

The Staff Pad is looking for a Revenue Cycle Specialist I in Nogales, Arizona. You will provide staff support to the Revenue Cycle Manager in maintaining and operating the firm’s business systems.

Essential Functions :

1. Patient Relations :

Demonstrate excellent patient relations skills by greeting patients warmly and engaging with care.

2. Team Support :

Respond positively and helpfully to requests from colleagues.

3. Claims Processing :

Process all insurance claims (electronic / hardcopy) timely, including :

Entering treatment codes into billing software (Nextgen) accurately.

Verifying patient demographics and insurance details.

Communicating with providers and clinical staff to resolve billing issues.

Submitting medical claims to clearinghouses / insurance companies.

Posting insurance payments / denials to patient accounts.

Resolving claim denials or rejections due to coding or missing information.

Following up on accounts until balances are cleared or moved to self-pay.

Managing credit accounts for refunds to insurance companies or patients.

Contacting insurers about claim denials or over payments.

Processing insurance correspondence and maintaining account records.

Stay updated on billing codes and medical terminology.

Train team members as needed.

4. Daily Reporting :

Create reports, verify payment entries, balance end-of-day postings, and maintain accurate logs.

5. Work Prioritization :

Prioritize and complete tasks promptly.

6. Claim Correspondence :

Handle claim correspondence with insurance companies, answer calls, and provide information.

7. Patient Assistance :

Help patients with forms, answer account inquiries, and address billing errors.

8. Patient Account Specialist Support :

Provide assistance when necessary.

9. Confidentiality Compliance :

Maintain HIPAA-compliant confidentiality for all patient accounts.

10. Professionalism :

Ensure courteous treatment of all patients and staff by the business office.

Requirements :

1. Understanding of medical billing practices, clinic policies, and procedures.

2. Familiarity with medical terminology, ICD-10, CPT, and HCPCS coding.

3. Knowledge of insurance company operations.

4. Proficiency with filing, computers, calculators, and office equipment.

5. Problem-solving and data interpretation skills for billing.

6. Ability to establish effective relationships with diverse groups.

7. Uphold confidentiality of sensitive information.

8. Clear and efficient communication skills.

9. Strong mathematical skills.

10. Poise and efficiency in responding to inquiries.

11. Bilingual proficiency (English / Spanish).

Educational Requirements :

High School Diploma or equivalent.

Preferred : Medical Administrative Assistant or Medical Billing and Coding Program.

Experience :

Minimum 5 years of experience in a medical office or medical billing role.

Healthcare certification preferred (additional experience may substitute for certification).

Eligibility for promotion based on managerial discretion and performance.

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Salary : $43,000 - $51,600

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