Senior Specialist, Revenue Cycle Commercial

Denver Health; Broadway; On-site; GBP 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a motivated Senior Specialist in Revenue Cycle Commercial to enhance their billing and collections team. This role is pivotal in ensuring accurate reimbursement for hospital and physician claims while providing mentorship to junior staff. You will leverage your expertise in insurance rules and regulations to resolve unpaid balances and improve departmental performance. With a focus on communication and data analysis, you will drive initiatives that contribute to the overall efficiency of the revenue cycle. Join a team dedicated to community service and diversity, where your contributions will be valued and celebrated.

Benefits

Up to 27 paid days off

Retirement contributions

Medical plans

RTD EcoPass

On-site fitness center

Childcare discounts

Tuition reimbursement

Career development opportunities

Qualifications

• 4-6 years of experience in hospital or medical office focusing on claims.
• Strong knowledge of insurance billing and processing regulations.

Responsibilities

• Manage accounts receivable and ensure timely payments.
• Train staff and develop training materials for effective communication.

Skills

Insurance Billing

Claim Submission

Analytical Skills

Communication Skills

Problem-Solving Skills

Attention to Detail

Education

High School Diploma or GED

Tools

Accounts Receivable Databases

Payer Systems

Provider Portals

Job description

We are recruiting for a motivated Senior Specialist, Revenue Cycle Commercial to join our team!

We are here for life's journey.
Where is your life journey taking you?

Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all:

Humanity in action, Triumph in hardship, Transformation in health.

Department: Billing and Collections

Job Summary

The Revenue Cycle Specialist Senior works under general supervision. This role provides financial, clerical, and administrative services to ensure efficient, timely, and accurate reimbursement of hospital and physician claims. Responsibilities include correspondence with insurance companies, patients, and other partners to resolve unpaid balances, customer service, billing, follow-up, cash application, reconciliation of payer remittances, denial management, and appeals. The role requires excellent knowledge of insurance rules, payor guidelines, regulatory requirements, claim submission, processing, and collections. Strong attention to detail and communication skills are essential. This position also serves as a resource and mentor for junior staff and supports departmental projects and initiatives.

Essential Functions

1. Maintain knowledge of revenue cycle functions and metrics. Manage accounts receivable to ensure timely payments. Initiate claims submissions, review accounts for accuracy, document contacts, identify trends, and perform root cause analysis on unpaid accounts. (50%)
2. Train staff, respond to inquiries, develop training materials, and build relationships with internal and external partners through effective communication. (20%)
3. Complete worklists and reports, analyze KPIs, identify drivers, and make data-driven recommendations to improve performance. (15%)
4. Utilize payer systems, provider portals, and internal applications. (10%)
5. Stay updated on regulatory requirements and communicate policy changes to stakeholders. (5%)

Qualifications

Education: High School Diploma or GED required

Work Experience: 4-6 years of hospital or medical office experience, focusing on claim submission, insurance follow-up, denials, and credit balances

Knowledge, Skills, and Abilities

• Intermediate knowledge of insurance billing, processing, payor rules, and regulations
• Strong communication, analytical, organizational, and problem-solving skills
• Ability to prioritize tasks independently and in a team
• Proficiency with software applications and information systems
• Knowledge of accounts receivable databases; typing speed of at least 35 WPM
• Attention to detail and professional work behavior

Additional Details

Shift: Days (United States of America)

Work Type: Regular

Salary: $23.97 - $35.96 / hr

Benefits

• Up to 27 paid days off, retirement contributions, medical plans, and more
• RTD EcoPass, on-site fitness center, childcare discounts, tuition reimbursement, career development, and other perks

Our Values

• Respect
• Belonging
• Accountability
• Transparency

All safety-sensitive positions require a pre-employment drug test. Denver Health is an integrated health care system committed to community service and diversity. We are an equal opportunity employer and value contributions from all community members. Applicants will be considered until the position is filled.