Revenue Cycle Specialist

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

📋 Description

• Oversee claims management by assessing payments, denials, registration challenges, appeals, and necessary research for all UBCP practices.

• Follow up on accounts that have inactive, ineligible, or unverifiable insurance coverage.

• Review, document, and process patient refunds, account modifications, and ensure follow-through on postings.

• Review and respond to assigned correspondence within a seven-day calendar period.

• Deliver customer service and carry out pre-collection activities for designated self-pay balances.

• Recognize patterns in rejected, denied, or unpaid claims and propose reimbursement solutions.

• Communicate effectively with practices, payers, patients, and internal stakeholders to resolve account-related issues.

• Document account activities, corrections, decisions, and process enhancements in the appropriate systems.

• Maintain a minimum accuracy rate of 95% while meeting productivity, quality, and timeliness benchmarks.

• Assist with Epic optimization, quality initiatives, compliance obligations, risk management, and other Revenue Cycle tasks as assigned.

• Share expertise, seek feedback, and collaborate with team members to achieve departmental objectives.

⛳️ Requirements

• High school diploma or its equivalent is mandatory.

• Minimum of five years of experience in healthcare accounts receivable, focusing on unadjudicated claim management, appeals, and pre-collection tasks.

• Proven experience in researching complex account issues, resolving non-coding denials, and collaborating with payers, practices, and patients to facilitate timely reimbursement.

• Familiarity with healthcare accounts receivable, insurance billing, revenue cycle compliance, and non-coding denial resolution.

• Understanding of medical terminology, payer regulations, managed care contracts, insurance criteria, and billing requirements related to credentialing.

• Strong analytical and problem-solving capabilities.

• Proficiency in Epic or other electronic health record or practice management systems, as well as Microsoft Excel, Word, Outlook, and web-based applications.

• Ability to juggle multiple priorities, work autonomously, and complete tasks accurately within set deadlines.

• Excellent verbal and written communication abilities, including diplomatic communication and conflict resolution techniques.

• Capacity to maintain effective working relationships with colleagues, practice personnel, leaders, patients, payers, and other stakeholders.

• Commitment to professionalism, confidentiality, cultural sensitivity, and respect for patient rights, safety, and ethical standards.

• Additional coursework or training in medical billing, healthcare administration, or a related field is preferred.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and career advancement.

• Supportive and collaborative work environment.