Revenue Cycle Specialist

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

📋 Description

• Ensure precise billing and prompt submission of both electronic and paper claims.

• Track claim statuses and investigate as well as resolve any denials or rejections.

• Record account activities, including adjustments and collections.

• Identify and evaluate denial trends, proposing improvements for processes and systems.

• Investigate and address unpaid, denied, and rejected claims, including communication with payers and necessary submission of denials.

• Manage EDI transactions, reconciling payer submissions, edits, and rejection reports.

• Collaborate with the Insurance Verification team to pinpoint upstream impacts on claim processing.

• Work in partnership with team members and other departments to further organizational goals and implement process enhancements.

• Conduct collection activities in line with payer guidelines and filing limits, ensuring comprehensive documentation.

• Review posted payments and execute account adjustments.

• Monitor patient accounts for non-payment, delays in payment, and billing discrepancies.

• Investigate and address patient billing inquiries.

⛳️ Requirements

• High school diploma or GED.

• Over 3 years of experience in RCM, with a strong preference for knowledge of accounts receivable processes.

• Capability to analyze claims data to identify trends and recommend mitigation strategies.

• Experience working in digital or virtual health environments.

• Familiarity with medical billing systems (e.g., Candid Health, Healthie).

• Extensive background in healthcare accounts receivable and collections.

• Strong attention to detail, emphasizing accuracy and prioritization.

• Outstanding oral and written communication skills with internal and external stakeholders.

• Proven ability in customer service, effectively resolving patient and payer inquiries.

• Working knowledge of medical coding principles, denial management, and payer-specific requirements.

• Ability to excel in a fast-paced, high-volume setting.

• Commitment to maintaining HIPAA and regulatory compliance standards.

• Comprehensive understanding of Medicaid, Medicare, and commercial insurance billing processes.

• Bilingual in Spanish is preferred.

• Proficiency in Microsoft Excel and Word is preferred.

🏝️ Benefits

• 100% remote position.

• Monday–Friday work schedule.

• Equal opportunity employer.

• Diverse and inclusive work environment.