
Experienced Billing RCM Professional
7 days ago
Revenue Cycle Specialist
Job Description: We are seeking a detail-oriented Revenue Cycle Specialist to join our team. In this role, you will play a crucial part in managing the billing processes to ensure timely and accurate submission of claims.
Responsibilities:
- Oversee the processing of claims to ensure compliance with payer guidelines and regulations.
- Review and address billing discrepancies, rejections, and denials, implementing corrective actions as needed.
- Develop and implement billing policies and procedures to improve accuracy and efficiency.
- Collaborate with coding, compliance, and other departments to ensure accurate coding and documentation.
- Analyse billing data and metrics to identify trends, issues, and opportunities for process improvements.
- Ensure proper follow-up on unpaid or denied claims and manage the appeals process.
- Stay informed about changes in U.S. revenue cycle management practices and federal regulations to ensure billing processes remain compliant and optimized.
Qualifications:
- Bachelor's degree in business administration, healthcare administration, finance, or a related field is required.
- Proven experience with billing systems, payer guidelines, and regulatory compliance.
- Strong understanding of U.S. revenue cycle management, including billing workflows, reimbursement methodologies, and common challenges.
- Up-to-date knowledge of federal regulations, policy changes, and industry standards impacting medical billing practices.
- Familiarity with billing software and electronic health records (EHR) systems.
- Strong attention to detail, analytical skills, and ability to work independently.
- Excellent communication and collaboration skills.
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