Revenue Cycle Management Specialist

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Establish robust partnerships with Hyderabad transactional teams to enhance account performance excellence.

• Prepare and submit medical service claims to insurance providers and patients.

• Gather essential documentation, including medical records, EOBs, remittances, authorizations, and referrals.

• Assess denied physician billing claims, verify coding accuracy, amend claims, and liaise with insurers to resolve and recover denied claims.

• Track aging reports and follow up on outstanding claims.

• Retrospectively review registration data to ensure clean claim submissions.

• Accurately document claim actions and resolutions in patient accounts and claims.

• Address registration, demographic, insurance, claim, and account-related issues.

• Collaborate with cross-functional teams, managers, and practice staff.

• Communicate resolutions for client issues and present monthly KPI trends.

• Comply with HIPAA confidentiality regulations regarding financial and medical information.

• Verify billing and coding accuracy prior to payer appeals or reconsiderations.

• Identify trends and patterns in denials to mitigate errors and enhance conversion rates.

• Coordinate with coders and billing managers to resolve claim coding issues.

• Keep abreast of compliance and regulatory changes.

• Utilize coding and medical terminology expertise to evaluate denials and appeals.

• Support initiatives aimed at process and quality improvement.

• Achieve supervisor-defined objectives for error-free work, transactions, processes, and compliance.

• Provide exceptional customer service, respond to patient and insurance inquiries, and follow up in a timely manner.

• Generate reports for management and communicate resolutions regarding payer denial trends.

• Identify missing payments, overpayments, and account credits.

• Reconcile deposit logs with posting reports.

• Maintain precise reimbursement records.

• Uphold UnisLink’s vision, mission, and core values.

• Safeguard sensitive information and adhere to UnisLink policies and procedures.

• Perform additional duties as assigned.

⛳️ Requirements

• A minimum of 3-5 years of experience in a Physician Billing department handling denials, appeals, insurance collections, and related follow-ups is essential.

• Experience with Medicaid, particularly AZ Medicaid.

• Comprehensive understanding of the complete claim cycle, including charge/claim submission, payments, and accounts receivable.

• Ability to interpret contract language with a thorough understanding of claims denial appeal logic.

• Extensive experience using search engines and the Internet.

• Proficiency in utilizing payer websites effectively.

• Familiarity with Microsoft products, including Outlook, Word, and Excel.

• Knowledge and proficiency in HIPAA compliance.

• Understanding of accepted healthcare insurance billing practices.

• Excellent written and verbal customer service and communication skills.

• Strong reasoning, critical thinking, analytical, and mathematical abilities.

• Demonstrated capacity to work independently, adapt flexibly between high-level and detailed tasks, maintain high productivity, and consistently meet deadlines.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance.

• Opportunities for professional development and career advancement.

• Flexible work environment with potential remote work options.

• Supportive team culture and collaborative work atmosphere.