Revenue Cycle Specialist

Job Summary

Working remotely in a full-time capacity, the Revenue Cycle Specialist will manage the full lifecycle of claims, including eligibility verification, claim submission, and accounts receivable follow-up, while directly engaging with client EHR and billing systems.

Key responsibilities:

• Verify insurance coverage and benefits, documenting details and determining payer order
• Submit clean claims directly to payers and resolve claim edits and denials at the source system level
• Analyze denial trends and collaborate with cross-functional teams to address issues impacting claim payments

Required qualifications:

• High School Diploma or GED; CRCR or CRCS certification preferred
• 3-5 years of revenue cycle experience in eligibility verification, billing, and denial management
• Hands-on experience submitting claims directly to payers, including Medicare and Medicaid
• Comprehensive knowledge of UB-04 and CMS-1500 claim forms and major payer processes
• Strong analytical skills and proficiency in Excel for data interpretation and management