Revenue Cycle Specialist

Cook Inlet Tribal Council; Anchorage (AK); Remote; USD 33,000 - 52,000; Full time

Job summary

Cook Inlet Tribal Council, Inc. in Anchorage, Alaska is seeking a Revenue Cycle Specialist I/II/III to ensure accurate billing and timely collections for behavioral health services, handling third-party payors and outpatient billing in a compliant manner.

The role requires expertise in payor contracts, regulatory requirements, and collaboration with providers and staff. This position supports CITC's programs while offering potential remote work as needed and a non-exempt full-time schedule.

Qualifications

• Experience with medical billing and revenue cycle processes.
• Knowledge of Federal and State billing regulations.
• Excellent communication and problem-solving skills.

Responsibilities

• Review and submit claims to third-party payors with accuracy.
• Post payments and verify posting accuracy.
• Follow up on denials and adjust accounts as needed.
• Maintain HIPAA privacy and compliance in all dealings.

Skills

Medical billing

Revenue cycle management

HIPAA compliance

Communication

Attention to detail

Problem solving

Education

High School Diploma or GED

Associate's degree in Accounting or related field

Tools

EHR systems

Billing platforms

Microsoft Office

Job description

• Base Pay $24.25 - $37.75 / Hour
• Job Category Revenue & Data Operations
• Employee Type Non-Exempt - Full Time

Contact information

• Name HR Department

Description

Job Title

Revenue Cycle Specialist I/II/III

Department

Revenue & Data Operations

Reports To

Revenue Cycle Manager

Supervises

None

FLSA Status

Non-Exempt

Pay Grade

N4 (I), N5 (II), N6 (III)

Job Type

Regular, Full-Time

AKBCU

Yes

ICPA

No

General Functions

The Revenue Cycle Specialist ensures accurate and timely billing and collections for CITC's behavioral healthcare services by managing third-party payor claims, account follow-up activities, and outpatient billing processes. This position requires expert knowledge of Federal and State regulatory requirements, payor contracts, and CITC billing policies to maximize revenue recovery while maintaining compliance. Working in partnership with our people, the Revenue Cycle Specialist helps develop opportunities that fulfill our endless potential by ensuring financial resources are efficiently managed to support CITC's programs and services. The role serves as a subject matter expert in specialized revenue cycle functions and provides cross-functional support as needed.

Duties and Responsibilities

Revenue Cycle Specialist I

• Review, analyze, and submit claims to third-party payors ensuring accuracy and compliance with Federal and State regulations.
• Post payments from third-party payors, Medicaid, and participants while verifying accuracy of payment and adjustment posting.
• Verify charge entry accuracy and make corrections as needed to ensure proper billing and reimbursement.
• Maintain communication with providers, participants, and insurance representatives regarding account issues and payment status.
• Meet department productivity goals and benchmarks while managing multiple tasks, projects, and deadlines simultaneously.
• Protect participant privacy in accordance with CITC policies and HIPAA regulations when handling protected health information.
• Assist other staff members to maintain current department workload and provide cross-functional coverage as needed.
• Perform all related duties as needed and assigned.

Revenue Cycle Specialist II

• Perform all duties and responsibilities above with an advanced level of proficiency.
• Research, correct, and resubmit unpaid or denied claims while tracking resolution through multiple EHR and billing platforms.
• Interpret explanation of benefits (EOB) to identify denials and underpayments, then negotiate with insurance carriers for proper reimbursement.
• Submit and track resolution of provider queries to ensure complete and accurate documentation for billing purposes.

Revenue Cycle Specialist III

• Perform all duties and responsibilities above with an advanced level of proficiency.
• Perform complex account follow-up activities by working aged receivables and utilizing A/R reports in revenue cycle management systems.
• Resolve registration and claim information issues by collaborating with clinical and administrative staff to ensure complete documentation.
• Submit third-party payor appeals and reconsideration requests within required timeframes to maximize revenue recovery.

Job Specifications

• Demonstrated knowledge of medical electronic billing procedures, coding, and revenue cycle processes.
• Strong problem-solving and decision-making skills with ability to research and resolve complex billing issues.
• Excellent verbal and written communication skills with strong customer service and negotiation abilities.
• Proficient computer skills including Microsoft Office applications and ability to navigate multiple EHR and billing platforms.
• High degree of accuracy and attention to detail with demonstrated proficiency in data entry.
• Knowledge of general accounting principles, medical insurance, and associated Federal and State regulations.
• Ability to work independently with minimal supervision while managing multiple priorities under pressure.
• Demonstrated knowledge and understanding of the social, health, educational, training, and cultural needs of the Alaska Native and American Indian community.
• Ability and willingness to work remotely as needed with appropriate technology and internet connectivity.

Minimum Core Competencies

CITC Values, Respectful Leadership, Professionalism, Emotional Intelligence, Problem Solving/Critical Thinking, Communication Skills.

Minimum Qualifications

• Continued employment is contingent upon completion of satisfactory state and federal fingerprint criminal background check.
• High School Diploma or GED.

Revenue Cycle Specialist I

• One (1) year of medical billing/revenue cycle experience.

Revenue Cycle Specialist II

• Associate's degree in Accounting or related field. Relevant work experience may substitute for education requirement on a year-for-year basis.
• Three (3) years of medical billing/revenue cycle experience.

Revenue Cycle Specialist III

• Associate's degree in Accounting or related field. Relevant work experience may substitute for education requirement on a year-for-year basis.
• Five (5) years of medical billing/revenue cycle experience.

Preferred Qualifications

• CRCR, CPC, or other industry certification.
• Alaska Behavioral Health billing experience (State Plan and/or 1115 Waiver).
• Experience with Alaska tribal/IHS billing and reimbursement.

Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

• May require prolonged periods of sitting at a desk and consistently working on a computer with repetitive motion.
• The need to occasionally move around the office to access filing cabinets, storage cabinets, and office equipment may be necessary.
• Must be able to lift up to 25 pounds occasionally by utilizing proper lifting techniques and working in a safe manner.

Disclaimer

The information provided in this description has been designed to indicate the general nature and level of work performed by incumbents within this job. It is not designed to be interpreted as a comprehensive inventory of all duties, responsibilities, qualifications and working conditions required of employees assigned to this job. Management has sole discretion to add or modify duties of the job and to designate other functions as essential at any time. This job description is not an employment agreement or contract.