Revenue Cycle Specialist

Job Summary

Working remotely in a full-time capacity, the Revenue Cycle Specialist will manage insurance billing operations, perform RCM functions from eligibility verification to collections, and provide exceptional partner support while ensuring compliance with industry standards.

Key responsibilities

• Perform RCM functions including eligibility verification, charge entry, claim submission, and collections while meeting collection goals
• Serve as a subject matter expert on insurance billing best practices and assist staff in applying effective revenue cycle management
• Identify and resolve issues affecting reimbursement and communicate findings to management for trend identification and resolution

Required qualifications

• 2+ years of experience in insurance eligibility verification and claims processing within a healthcare setting
• Strong knowledge of CPT, HCPCS, and ICD-10 codes, as well as HIPAA regulations
• Understanding of NPI, taxonomy, and electronic claim submission requirements
• In-depth knowledge of insurance A/R and the ability to interpret ERA/EOB/EOPs
• Experience with Candid or similar billing systems preferred, along with familiarity with 270/271 X12 files