Revenue Cycle Specialist

Job Summary

Focused on timely follow-up of outstanding insurance claims, the full-time Revenue Cycle Specialist will analyze account activity, investigate denied claims, and collaborate with insurance payers and internal departments to ensure accurate reimbursement.

Key responsibilities

• Follow up on assigned insurance claims to ensure timely and accurate payment
• Review Explanation of Benefits (EOBs) and remittance advice for payment accuracy and claim status
• Contact insurance companies to resolve claim issues and appeal denied or underpaid claims

Required qualifications

• High school diploma or equivalent required; Associate's degree in healthcare or business preferred
• Minimum of 4 years of experience in medical billing, insurance follow-up, or revenue cycle operations
• Experience with Indian Healthcare, Commercial Payers, and worker compensation accounts
• Knowledge of insurance payer requirements, CPT/ICD coding, and medical terminology
• Strong understanding of healthcare claim submission and adjudication processes