Revenue Cycle Specialist I - Billing Customer Service

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Join our team as a Revenue Cycle Specialist, where you'll play a key role in supporting patients and providers by resolving billing issues, handling inquiries, and ensuring client satisfaction. You'll take approximately 45-55 inbound calls per day, onsite and will have a set schedule Monday-Friday between the hours of 7am-5:30pm. If you have experience in high-volume contact centers, possess strong de-escalation skills, and enjoy helping people, we’d love to meet you! Being bilingual (Spanish/English) and having medical/healthcare/insurance experience are big pluses as well. Join us and be part of a supportive team that values great service and a positive attitude. You belong here!

POSITION SUMMARY
This position is responsible for performing revenue cycle functions for all patient, client, and third-party billing and operations while supporting the department key performance indicators and the company’s mission and goals.

Performs all functions according to established policies, procedures, regulatory and accreditation requirements, as well as applicable professional standards.

CORE FUNCTIONS
1. Completes data entry tasks including but not limited to; account documentation, entry of laboratory orders, payment posting/reconciling and claims submissions while meeting quality and productivity standards.

2. Resolves revenue cycle related items that include but are not limited to; demographic updates, claim and error corrections (appeals, denials, claim status errors, internal errors). Responsible for obtaining and accurately updating missing information, as well as performing verification of eligibility.

3. Responsible for account review/reconciliation and auditing including but not limited to; payment verification, posting adjustments, requesting refunds, and general account reconciliation.

4. Reviews automation exceptions, validates outputs, identifies issues, and escalates workflow, data or compliance concerns.

5. Escalates trends to leadership and staying current on all departmental and compliance policies, procedures and all applicable laws and regulations.

6. Demonstrates excellent customer service for internal and external clients and patients via any channel of communication including but not limited to in person, over the phone or written correspondence.

NOTE: The core functions are intended to describe the general content and requirements of this position and are not intended to be an exhaustive statement of duties. Specific tasks or responsibilities will be documented as outlined by leadership.

KNOWLEDGE, SKILLS AND ABILITIES

• Ability to communicate complex issues using strong verbal and written aptitude clearly and efficiently.

• Working knowledge of billing, insurance, computer systems, and medical billing processes.  
• Ability to prioritize and complete multiple tasks.
• Excellent communication skills, both written and verbal.
• Excellent organizational skills.
• Intermediate computer knowledge with various programs/software. 
• Ability to work independently and accurately with high volumes of data and minimal supervision.

• Ability to effectively interface with patients and/or clients

• Basic working knowledge of Microsoft Office Suite with an emphasis on excel

• Must be able to recognize problems, identify the cause and determine solutions

MINIMUM QUALIFICATIONS

• High school diploma or equivalent

• One (1) year experience in a healthcare or corporate setting

PREFERRED QUALIFICATIONS

• Understanding of CMS regulations
• Additional related education and/or experience.  

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