Revenue Cycle Specialist
Revenue Cycle Specialist
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Not Disclosed
Salary Not Disclosed
1 Vacancy
Job Description
The Revenue Cycle Specialist plays a crucial role in managing billing processes and facilitating smooth electronic data exchanges between healthcare providers payers and regulatory agencies. This includes overseeing outstanding claims and accounts receivable managing payer and software interfaces and working with both payers and patients to streamline claims and payment procedures.
Responsibilities include:
- Revenue Cycle Management:
- Coordinate and manage the billing process to ensure timely and accurate submission of claims.
- Monitor outstanding claims and accounts receivable to identify and resolve issues promptly.
- Manage patient statements and collections. Ensure that patient charges are accurately reflected process patient payments and address billing inquiries or discrepancies.
- Provider Enrollment Management:
- Facilitate the provider enrollment process for medical and dental practitioners ensuring compliance with regulatory requirements and payer guidelines.
- Collaborate with internal departments to gather necessary documentation and information for provider credentialing.
- Maintain accurate records of provider enrollment status and communicate updates to relevant stakeholders.
- CAQH Management:
- Oversee the CAQH (Council for Affordable Quality Healthcare) ProView system for all providers within the organization.
- Coordinate initial setup and ongoing maintenance of provider profiles in the CAQH system ensuring completeness and accuracy of data.
- Regularly update provider information attestations and supporting documents in accordance with CAQH guidelines.
- Electronic Data Interchange (EDI) Administration:
- Manage electronic data interchange processes for medical and dental claims submission eligibility verification and electronic remittance advice (ERA).
- Collaborate with IT personnel and external vendors to configure and maintain EDI interfaces with payers and clearinghouses.
- Monitor EDI transactions for accuracy and completeness troubleshooting any issues that may arise.
Our team enjoys great benefits including medical dental vision 6 paid holidays 2 floating holidays generous paid time off that starts to accrue on your first day and a 403(b)-retirement option. This position will have a Monday - Friday (5 day/8 hour) schedule and may offer support to other sites as needed based on business needs.
If interested please apply today by submitting your cover letter and resume. Upload all materials into the cover letter and resume submission fields. Applications that do not contain all required documents may not receive full consideration.
Visit to learn more about Rockbridge Area Health Center. For questions about the application process please contact Human Resources by calling or EOE
Required Experience:
Manager
Employment Type
Full-Time
