Revenue Cycle Specialist
Job Summary
Working remotely in a full-time capacity, the Revenue Cycle Specialist will manage the full lifecycle of claims from eligibility verification to final account resolution, focusing on billing directly to payers and resolving claim issues efficiently.
Key responsibilities:
- Verify insurance coverage and benefits, documenting details for claims processing
- Submit clean claims directly to payers and resolve front-end claim edits and rejections
- Analyze denial trends and collaborate with internal teams to address upstream issues affecting 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 AR follow-up
- Hands-on experience with direct claim submission to Medicare, Medicaid, and commercial payers
- Comprehensive knowledge of UB-04 and CMS-1500 claim forms and associated coding
- Strong analytical skills and proficiency in Excel for data management
Complete Job Description
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