Revenue Cycle Specialist

Overview

The Revenue Cycle Specialist is responsible for the revenue cycle of the Jackson Clinic professional billing process to ensure appropriate and timely coding, billing, and collections. The Revenue Cycle Specialist will be responsible for working queries sent from the 3rd party billing company to resolve errors, entering hospital charges for all providers, and working end of month reports to ensure accuracy.

The Revenue Cycle Specialist will answer patient billing questions and act as a resource for staff for billing questions. In addition to revenue cycle, this position will be a super user of the electronic medical record and front-end processes of all primary care, walk-in, and specialty clinics. Monitors the daily submission of charges to the third party billing company for accuracy and timeliness, and follows up directly with providers to address billing issues.

Facilitates all coding recommendations from third party billing company to individual providers daily. Works queries from 3rd party billing company to correct errors on denied claims. Completes the daily logs for point of service collections, cash reconciliation, payment posting, and bank deposits. Helps Revenue Cycle Manager educate appropriate revenue cycle processes in all clinic offices which include but not limited to patient registration, insurance verification, point of service collections, and provider coding.

Assists various offices with prior authorizations for surgeries, procedures, special medication administration as needed. Assists the clinic administration with routine billing and month-end reporting. Reports to management any variances that occur in the billing process. Compiles physician stats at end of month for clinic administration. Works to enter all hospital charges, nursing home charges, and palliative care charges to submit to 3rd party billing company.

Completes credentialing and appointment packets for physicians as needed. Performs all other duties as deemed necessary by the clinic administrator.

• Manage the revenue cycle of the Jackson Clinic professional billing process to ensure appropriate and timely coding, billing, and collections.
• Work queries from the 3rd party billing company to resolve errors.
• Enter hospital charges for all providers.
• Monitor daily submission of charges to the third party billing company for accuracy and timeliness; follow up with providers to address billing issues.
• Facilitate all coding recommendations from the third party billing company to individual providers daily.
• Work queries from the 3rd party billing company to correct errors on denied claims.
• Complete daily logs for point of service collections, cash reconciliation, payment posting, and bank deposits.
• Educate appropriate revenue cycle processes in all clinic offices (patient registration, insurance verification, point of service collections, and provider coding) in collaboration with the Revenue Cycle Manager.
• Assist offices with prior authorizations for surgeries, procedures, and special medication administration as needed.
• Assist clinic administration with routine billing and month-end reporting.
• Report variances in the billing process to management.
• Compile physician statistics at end of month for clinic administration.
• Enter hospital, nursing home, and palliative care charges for submission to the 3rd party billing company.
• Complete credentialing and appointment packets for physicians as needed.
• Perform all other duties as deemed necessary by the clinic administrator.

• High school diploma.
• Minimum of 1-2 years experience in medical billing in a physician office or physician office related setting.
• Certification in Physician Coding with AAPC preferred.
• Excellent verbal and written communication required, telephone etiquette, customer relations’ skills, CPT and ICD Coding.
• Computer literate.
• Manual dexterity and visual acuity necessary to utilize the PC and calculator.
• Ability to sit for prolonged periods of time.
• Verbal communication and hearing ability to communicate with a multitude of patients and customers.