Revenue Cycle Specialist (Biller)

Remote Worker - N/A; United States; On-site; USD 30,000 - 47,000; Full time

Job summary

Remote Worker is seeking a Revenue Cycle Specialist (Biller) to manage charge review, coding accuracy, and denial resolution. The role requires analyzing CPT/ICD-10 coding for physician services and performing timely follow-up on outstanding accounts receivable using payer portals and worklists.

Strong knowledge of medical terminology and third-party billing guidelines is essential, along with the ability to work independently in a fast-paced environment and communicate effectively with clients

Qualifications

• Knowledge of third-party billing and collection regulatory guidelines.
• Ability to gather and interpret clinical data.

Responsibilities

• Review initial charges to determine ICD-10 and CPT codes for physician services.
• Research and resolve insurance denials from remittances, correspondence, or Clearinghouse rejections.
• Provide timely follow-up on outstanding AR using practice worklists and payer portals.
• Communicate denials and trends to the practice.
• Collaborate with RMC team to ensure account accuracy and issue resolution.
• Explain payer billing guidelines to clients and staff.
• Meet or exceed client AR objectives across aging categories (30,60,90+).
• Perform other related duties as required.

Skills

Medical terminology

Interpersonal skills

Independent worker

Communication skills

Education

High school diploma or GED

Billing or Coding Certification (CPC, CPC-A, COPC, CPB)

Job description

Revenue Cycle Specialist (Biller)

Required to answer patient phone calls. Work denials and worklist within 24 hours of receipt. Work Accounts Receivables report within benchmarks. Work Unbilled/Exclusion list within 24 hours of receipt. Work Denials related to coding issues.

Duties/Responsibilities:

• Performs initial charge review to determine appropriate ICD-10 and CPT codes to be used to report physician services to third-party payers.
• Review and research insurance denials received through insurance remittances, correspondence, or Clearinghouse rejections in an accurate and timely manner.
• Provide timely and efficient follow-up on all outstanding AR using assigned by the practice management worklist reports, using various systems including payer portals, phone inquiries, and/or written communications.
• Ensure timely communication of denials or trends that require the practice's knowledge and/or actions.
• Work collaboratively with other RMC team members and offices to ensure overall account accuracy and issue resolutions are completed.
• Effectively communicate payer billing guidelines to clients and other staff in a timely manner.
• Consistently meets and/or exceeds client AR objectives in each outstanding aging category (30,60,90+) Work denials and worklist within 24 hours of receipt.
• Performs other related duties as required and assigned.

Requirements

• Good working knowledge of medical terminology and anatomy is required.
• Knowledge of current third-party billing and collection regulatory guidelines and requirements.
• Good interpersonal skills and a basic understanding of team management concepts.
• Ability to gather and interpret clinical data.
• Ability to work independently in a fast-paced environment.
• Demonstrate excellence in communication skills, ability to convey information verbally and in writing

Education and Experience:

• A high school diploma or GED completion is required.
• Billing or Coding Certification (CPC, CPC-A, COPC, CPB) or willing to obtain certification within 6 months of employment.
• Two (2) years experience with CPT ICD-10 coding of physician services preferred.