Revenue Cycle Specialist

• Entry level position responsible for submitting and resolving medical claims of low to moderate complexity.
• Must remain current with governmental and third party billing, follow-up and appeal requirements for compliant billing and follow-up of both inpatient and outpatient claims for all wholly owned facilities and physician entities including internal and external policy requirements.
• Responds to requests from management, staff, or physicians in a timely and appropriate manner.
• Maintains patient and physician confidentiality and professionalism at all times.
• Follows department policies and procedures to ensure accurate and timely claim resolution.
• Effectively communicates utilizing telephone, form letters, e-mail, or internal correspondence to resolve patient inquiries and insurance issues.
• Attends and participates in team meetings.
• Utilizes worklists to review and analyze account balances in order to collect payment for medical services rendered.
• Utilizes multiple system applications to review, update patient information as well as research and resolve outstanding AR balance.
• Assists in the analysis of claims resolution and provides feedback to management for solutions and process improvements.
• Performs follow up with insurance companies to ensure appropriate payment on claims, resolve denials, correct claims, and appeal claims.
• Acts as a liaison with internal and external customers providing assistance in claims and receivables resolution in a high volume environment.
• Contacts patients and guarantors to secure necessary billing information.
• Documents accounts with clear and concise verbiage in accordance with departmental procedures.
• Reviews and responds to correspondence and inquiries received.
• Meets and exceeds team productivity and quality standards.
• Performs other related duties as assigned.

Entry level position resolving medical claims in a hybrid work environment

Revenue Cycle Specialist I

Entry level position resolving medical claims in a hybrid environment while ensuring compliance with billing standards. Contributing to accurate claim resolution for both inpatient and outpatient services.

• Position responsible for submitting and resolving medical claims moderate to high complexity.
• Responds to requests from management, staff, or physicians in a timely and appropriate manner.
• Maintains patient and physician confidentiality and professionalism at all times.
• Follow department policies and procedures to ensure accurate and timely claim resolution.
• Effectively communicates utilizing telephone, form letters, e-mail, or internal correspondence to resolve patient inquiries and insurance issues.
• Attends and participates in team meetings.
• Utilizes worklists to review and analyze account balances in order to collect payment for medical services rendered.
• Utilizes multiple system applications to review, update patient information as well as research and resolve outstanding AR balance.
• Assists in the analysis of claims resolution and provides feedback to management for solutions and process improvements.
• Performs follow up with insurance companies to ensure appropriate payment on claims, resolve denials, correct claims, and appeal claims.
• Acts as a liaison with internal and external customers providing assistance in claims and receivables resolution in a high volume environment.
• Documents accounts with clear and concise verbiage in accordance with departmental procedures.
• Reviews and responds to correspondence and inquiries received.
• Meets and exceeds team productivity and quality standards.
• Takes the lead on special projects.
• Participates in staff training.
• Reviews complex claims issues for resolution and recommends process improvements.
• Performs other related duties as assigned.

Responsible for resolving medical claims in a fast-paced environment

Revenue Cycle Specialist II, Credit Management

Responsible for submitting and resolving medical claims. Must handle both inpatient and outpatient claims for compliance in a fast-paced medical environment.

Revenue Cycle Specialist jobs in Ohio

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Revenue Cycle Specialist I

Revenue Cycle Specialist II, Credit Management