About the Role
We are seeking a proactive, detail-oriented Revenue Cycle Specialist to manage key aspects of the revenue cycle process, including denial management, financial counseling, and cash posting. In this role, you’ll collaborate with insurance companies, patients, and internal teams to ensure claims are resolved promptly, collections are optimized, and patients have an exceptional financial experience. You’ll also analyze payment trends, identify opportunities for process improvement, and contribute to month-end closing activities. This role reports to the Director of Revenue Cycle Management.
Responsibilities:
Denial Management
- Analyze and resolve denied insurance claims promptly.
- Identify trends in denials and recommend process improvements to reduce future rejections.
- Collaborate with insurance companies and internal teams to appeal and overturn denials.
- Document all denial management activities thoroughly and accurately.
Financial Counseling
- Provide patients with clear explanations of their financial obligations.
- Assist patients in understanding insurance benefits and coverage.
- Offer guidance on payment plans and financial assistance programs.
- Ensure compliance with all regulatory requirements related to patient financial communications.
Cash Posting
- Accurately post payments from patients and insurance companies to the appropriate accounts.
- Reconcile daily/weekly cash receipts and prepare deposit reports.
- Investigate and resolve any discrepancies in payment postings.
General Duties
- Work closely with the billing and authorization teams to reduce denials and underpayments.
- Stay updated on insurance policies and regulatory changes.
- Support month-end closing activities related to revenue cycle processes.
- Actively participate in team meetings and contribute to team goals.
What You Need to Succeed in the Role
- 3-5+ years in claims billing, revenue cycle management, or a related field.
- Bachelor’s degree in Business, Healthcare Administration, or a related discipline.
- Strong analytical ability to review claims data, spot trends, and implement improvements.
- Exceptional organizational skills with meticulous attention to detail.
- Excellent written and interpersonal communication skills.
- Ability to work independently in a fast-paced, dynamic environment while adapting to new systems and processes quickly.
- Capacity to handle sensitive and confidential information with integrity and build trust.
- Ability to maintain a distraction-free home workspace and reliable internet for consistent audio/video communication.