Revenue Cycle Specialist

Overview

Unified Women’s Healthcare is a company dedicated to caring for Ob‑Gyn providers who care for others, be they physicians or their support staff. A team of like‑minded professionals with significant business and healthcare experience, we operate with a singular mindset - great care needs great care. We take great pride in not just speaking about this but executing on it.

As a company, our mission is to be an indispensable source of business knowledge, innovation and support to the practices in our network. We are advocates for our Ob‑Gyn medical affiliates – enabling them to focus solely on the practice of medicine while we focus on the business of medicine.

We are action oriented. We strategize, implement and execute – on behalf of the practices we serve.

The Revenue Cycle Specialist is responsible for resolving claim issues including denials, payment variances, and any other unresolved issues that may arise directly from internal and external customers. There is an expectation of consistent and clear communication to multiple internal and external entities to collaborate and resolve issues.

• 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

• 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