Revenue Cycle Specialist

Talentify; San Antonio (TX); On-site; USD 42,000 - 65,000; Full time

Job summary

Talentify is seeking a billing/revenue cycle professional in Texas to support timely payments and accurate claim processing. The role involves processing claims, reviewing denials, updating patient coverage, and communicating with patients and staff to resolve discrepancies.

You will work within a team, maintaining regulatory knowledge and contributing to process improvements while ensuring high-quality, timely service for providers and patients alike.

Qualifications

• Experience in revenue cycle/billing processes required.
• Ability to work as part of a team and communicate effectively with patients and staff.
• Strong attention to detail and high accuracy in handling claims and data.

Responsibilities

• Maintains detailed knowledge of revenue cycle functions.
• Reviews and completes work log tasks by processing claim edits, denials, and aging tasks.
• Works accounts receivable to ensure timely payments from insurance.
• Initiates claim submissions and performs account review for accuracy.
• Identifies trends, conducts follow-up, and performs root cause analysis on unpaid accounts.
• Responds to inquiries from patients or staff.
• Keeps current knowledge of regulatory requirements and communicates updates to Manager and team.
• Performs insurance eligibility verifications and updates patient coverage as needed.
• Reviews charges for accuracy and medical necessity; resubmits corrected claims.
• Manages work queues and follows up with payers on unpaid or denied claims via various channels.
• Documents interactions with insurance companies using designated methods.
• Manages requests for information/medical records for claim adjudication.
• Communicates billing inquiries to patients and resolves discrepancies.
• Works as part of a cohesive team and covers for others when needed.
• Performs additional duties as assigned.

Skills

Revenue cycle/Billing

Team Player

Self-Starter

Detail Oriented

Customer service

Job description

Below is a listing of job duties/responsibilities:

• Maintains detailed knowledge of revenue cycle functions.
• Reviews and completes work log tasks in the system by working through claim edits, denials, and aging tasks; turns in daily productivity reports as required.
• Works accounts receivable to ensure timely payments from insurance.
• Initiates claim submissions, performs account review, and ensures work is accurate and complete.
• Identifies trends, conducts follow-up, and performs root cause analysis on unpaid accounts.
• Responds to inquiries and calls from patients or staff members.
• Reviews websites, bulletins, and other resources to maintain current knowledge of regulatory requirements and relays information to Manager and team members.
• Performs insurance eligibility verifications and updates patient coverage as needed.
• Reviews charges for accuracy, completeness, modifiers, and medical necessity; corrects as necessary and submits timely. Corrects and resubmits rejected claims.
• Manages work queues for assigned providers; follows up with third-party payers on unpaid or denied claims via portals, phone, chat, email, and appeals as necessary.
• Documents contact with insurance companies and others using appropriate designated methods.
• Manages and responds to payer requests for information/medical records for claim adjudication.
• Communicates with patients about billing inquiries and discrepancies.
• Works as part of a cohesive team, providing coverage for other team members as needed.
• Performs additional duties as assigned.

Qualifications

Experience

Preferred

Revenue cycle/Billing

Behaviors

Required

Team Player:Works well as a member of a group

Enthusiastic:Shows intense and eager enjoyment and interest

Dedicated:Devoted to a task or purpose with loyalty or integrity

Detail Oriented:Capable of carrying out a given task with all details necessary to get the task done well

Motivations

Required

Self-Starter:Inspired to perform without outside help

Equal Opportunity Employer
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