Billing & Revenue Cycle Specialist

Fiesta Health; Georgia; Remote; USD 25.003 - 35.610; Teilzeit

Zusammenfassung

A healthcare provider is seeking a Billing & Revenue Cycle Specialist based in Georgia for part-time remote work. This role involves ensuring accurate billing, managing service authorizations, and conducting daily eligibility checks. The successful candidate will need to maintain compliance and support team operations effectively. Strong organizational skills and attention to detail are essential, along with experience in billing processes and insurance management. This position offers flexibility and the opportunity to impact the revenue cycle positively.

Qualifikationen

• Experience with billing and revenue cycle management.
• Strong attention to detail and organizational skills.
• Ability to manage and track authorizations efficiently.

Aufgaben

• Support accurate billing and manage authorizations for services.
• Conduct daily coverage and eligibility checks for clients.
• Maintain documentation for billing and insurance compliance.

Kenntnisse

Accurate billing

Insurance checks

Audit readiness

Team collaboration

Jobbeschreibung

Reports to: CEO
Location: Remote (based in Georgia, USA; occasional travel required)
Position Type: Part-Time
Pay: $22/hour

Position Overview

The Billing & Revenue Cycle Specialist supports Fiesta Health’s team by ensuring accurate billing, managing authorizations for ongoing services, and maintaining revenue integrity through daily insurance checks, COB management, and audit readiness. This role owns backend billing workflows and ensures claims, payments, and authorizations remain compliant and up to date.

Key Responsibilities

Billing & Revenue Cycle Management (RCM)

• Track and log “Ready to Bill” approvals across all business units daily.
• Enter, review, and audit billing data in the system to ensure accuracy.
• Submit claims, monitor denials, and elevate billing issues to leadership.
• Prepare utilization and billing reports for internal audits.
• Support and lead insurance audits, documentation requests, and updates.
• Maintain liability and insurance documentation for all payors.

Ongoing Service Authorizations

• Manage reassessment authorizations and renewals for ABA services.
• Submit and track authorizations for ongoing treatment plans.
• Monitor expiration dates to avoid service disruptions.
• Follow up with clinicians to ensure assessment documentation is submitted on time.

Daily Eligibility Checks

• Complete daily coverage and eligibility checks for existing clients.
• Update internal systems with changes in eligibility or coverage.
• Communicate any discrepancies or lapses to leadership immediately.

Coordination of Benefits (COB)

• Identify and resolve COB issues that impact claim processing.
• Communicate required updates to families and document follow-up.
• Work with payors to ensure accurate primary/secondary insurance designation.

Operations & Systems Support

• Review database entries for accuracy and SOP compliance.
• Maintain up-to-date SOPs for billing, authorizations, and insurance workflows.
• Assist with accounts payable and financial reporting as needed.
• Support credentialing workflows for clinical staff.

Team Collaboration

• Lead weekly billing meetings and team calls by facilitating discussion, maintaining structure, ensuring accountability, and keeping the team aligned on priorities. This includes preparing agendas, auditing billing data ahead of each meeting, identifying issues or trends, and driving action items to completion as billing volume scales.
• Join leadership meetings as needed for RCM updates.
• Provide clear communication and follow-up on billing and insurance-related tasks.