Revenue Cycle Specialist

Summary

Unified Women's Healthcare is a nationwide community of women's healthcare providers and operations specialists. The Revenue Cycle Specialist resolves accounts receivable and claim issues, including denials, payment variances, reimbursement discrepancies, and payer-related concerns, while communicating with practices, payers, and other stakeholders. The role also reviews third-party work and generates reports as needed.

Responsibilities

• Resolve Accounts Receivable and Collections, including
• Review, Follow Up, and Appeal denied claims according to standards
• Determine accuracy of Insurance payments and follow up on discrepancies
• Initiate, Follow Up, and Respond on payer reimbursement issues
• Communicate with Practices and Payers regarding claim denials and payer trends
• Analysis and Quality Review of work completed by third parties
• Build and generate reports, as needed

Skills

• High school diploma or equivalent
• Post secondary degree preferred
• Minimum of 2 years current experience interpreting insurance explanation of benefits, patient benefit plans; policy coverage and patient responsibility
• Minimum of 2 years current experience working with medical claims, billing and collections, and appeals
• OB/GYN specialty preferred
• Experience working with healthcare practice management systems, (Athenanet preferred)
• Experience working with cloud-based Customer Relationship Management (CRM) technology (Salesforce preferred)
• Experience with Microsoft Office with proficiency with Microsoft Excel
• Excellent verbal and written communication skills with internal and external customers
• Ability to collaborate effectively in a cross-functional team environment
• Experience and knowledge of commercial and governmental insurance payer and clearinghouse portals (Availity, Navinet, Optum, etc.) including billing guidelines and policy updates
• Working knowledge of Medical Billing & Coding required
• Certification preferred

Qualifications

Must Haves

• High school diploma or equivalent

Nice to Haves

• post secondary degree preferred
• Minimum of 2 years current experience interpreting insurance explanation of benefits, patient benefit plans; policy coverage and patient responsibility
• Minimum of 2 years current experience working with medical claims, billing and collections, and appeals
• OB/GYN specialty preferred
• Experience working with healthcare practice management systems, (Athenanet preferred)
• Experience working with cloud-based Customer Relationship Management (CRM) technology (Salesforce preferred)
• Experience with Microsoft Office with proficiency with Microsoft Excel
• Excellent verbal and written communication skills with internal and external customers
• Ability to collaborate effectively in a cross-functional team environment
• Experience and knowledge of commercial and governmental insurance payer and clearinghouse portals (Availity, Navinet, Optum, etc.) including billing guidelines and policy updates
• Working knowledge of Medical Billing & Coding required
• Certification preferred

Benefits

• Medical, dental, and vision plans
• Fertility benefits
• Supplemental insurance options
• Vacation, personal days, and paid holidays
• 401(k) with employer contribution
• Flexible Spending Accounts (FSAs)
• Health Savings Accounts (HSAs)
• Short- and long-term disability
• Paid parental leave
• Basic life insurance
• Optional additional coverage
• Employee Assistance Program
• Commuter benefits
• Pet insurance
• Identity theft protection
• Opportunities and resources to support your career growth