Billing & Revenue Cycle Specialist Occupational Health

The Billing & Revenue Cycle Specialist provides revenue cycle and administrative support for Occupational and Employee Health services including billing accounts receivable follow-up denial resolution cash handling employer account maintenance documentation management and coordination of daily operational support activities. This role collaborates with clinical staff employers payers and internal departments to support timely reimbursement regulatory compliance and efficient clinic operations.

Education Licensure Certification and Experience requirements:

• High School diploma or equivalent required
• Associates degree preferred
• Certified Revenue Cycle Specialist (CRCS) required
• Minimum two (2) years experience in medical billing credit and collections required.

Competencies Knowledge Skills and Abilities:

• Knowledge of revenue cycle processes including billing accounts receivable and denial resolution.
• Familiarity with electronic claims submission remittance processing (ERA) and electronic funds transfer (EFT).
• Strong analytical and problem-solving skills with the ability to resolve claim discrepancies.
• High level of accuracy and attention to detail in data entry and financial reconciliation.
• Ability to prioritize and manage multiple tasks in a fast-paced clinical environment.
• Proficiency in Microsoft Office applications including Word and Excel.
• Ability to learn and effectively utilize SYSTOC EMR and related software systems.
• Strong organizational skills with the ability to maintain confidential records.
• Effective interpersonal and customer service skills.
• Strong written and verbal communication skills.
• Strong initiative with ability to independently prioritize and manage workload
• Adaptability and initiative in managing workload and responding to change.

Essential Job Duties:

Revenue Cycle/Accounts Management

• Process daily monthly and ad hoc billing for Occupational Health and Employee Health services including insurance workers compensation and direct-to-employer accounts.
• Perform charge entry payment posting daily deposits and accounts payable/accounts receivable functions within SYSTOC and in coordination with the Augusta Health centralized billing department.
• Oversee assigned accounts receivable to ensure claims are processed to completion and reimbursement is optimized.
• Identify and resolve invalid incomplete or missing claim data prior to and following claim submission.
• Research and resolve denied claims including preparation and submission of appeals; correct claim data and rebill as appropriate.
• Maintain working knowledge of payer standard transaction sets including electronic claim submission electronic remittance advice (ERA) code sets and electronic funds transfer (EFT) processes to ensure timely payment and account resolution.
• Support the acquisition and verification of required referrals authorizations workers compensation data and claim numbers necessary for treatment coordination and claim submission.
• Respond promptly to payer employer and patient correspondence regarding billing and claims.

Cash Handling & Financial Reconciliation

• Coordinate daily cash flow processes including balancing cash drawers and reconciling daily deposits.
• Monitor deferred revenue records and related tracking spreadsheets.
• Maintain accurate and organized departmental billing files.
• Prepare and distribute daily and monthly billing and revenue reports to department leadership.

Systems Data Management & Documentation

• Accurately enter and maintain employer account information and data new company set-ups and company-specific requirements within SYSTOC and the OH/EH database.
• Record and coordinate medical records requests within SYSTOC in accordance with department procedures.
• Maintain proficiency in SYSTOC EMR and other systems utilized in the day-to-day functions of Occupational and Employee Health.

Coordination & Department Support

• Serve as liaison between employers insurance carriers workers compensation representatives nursing staff providers and department leadership to facilitate communication and timely resolution of billing matters.
• Assist in coordinating off-site client testing and scheduling in collaboration with occupational health nurses.
• Assist with development review and revision of company agreements as requested.
• Collaborate with Augusta Healths Workers Compensation and Risk Management teams to support safety reporting data entry and related initiatives.
• Maintain departmental office forms supplies and administrative materials necessary to support daily clinic operations.
• Maintain and organize employer and company records ensuring documentation is current complete and accessible.
• Perform record retrieval copying and related documentation support in accordance with department procedures and regulatory guidelines.
• Provide on-site clinic assistance as needed to support patient flow and operational efficiency.
• Provide front desk coverage and administrative support as needed to maintain departmental operations.

Compliance Analysis & Process Improvement

• Provide regular feedback to leadership regarding payer issues recurring denials provider office issues and other barriers to timely payment.
• Identify patterns and trends in claim denials or payment delays and escalate systemic issues to leadership.
• Remain informed of federal and state billing regulations and guidelines; report compliance concerns to leadership.

Some benefits of working at Augusta Health include:

• Generous paid time off to promote work life balance
• Competitive Pay
• Retirement Plan
• Medical Dental and Vision Benefits
• Free onsite parking
• Tuition reimbursement
• Onsite childcare

Company Information:

Augusta Health is a mission-driven independent nonprofit community health system located in Fishersville Virginia in Virginias scenic Shenandoah Valley. Augusta Health offers a full continuum of inpatient and outpatient services which includes Augusta Medical Center a 255 bed inpatient facility and Augusta Medical Group which is comprised of 40 practice locations and four urgent care locations.

Equal Opportunity:

Augusta Health recruits hires and promotes qualified candidates for employment without regard to age color disability gender identity or expression marital status national or ethnic origin political affiliation race religion sex (including pregnancy) sexual orientation veteran or military discharge status and family medical or genetic information.

Required Experience:

IC