Revenue Cycle Specialist: Claims & Denials

Stance Health Solutions, Inc; California (MO); On-site; USD 55,000 - 70,000; Full time

Job summary

Stance Health Solutions, Inc is seeking a Revenue Cycle Coordinator to manage the end-to-end revenue cycle, including claims submission, denial follow-up, and payer communications. The role requires collaboration with internal teams and external payers to optimize cash flow.

The candidate will review insurance billing information, resolve discrepancies, and support global teams with QA and process improvements. Strong MS Office skills and healthcare billing knowledge are essential.

Qualifications

• Minimum one year of customer service experience.
• High school diploma or equivalent.
• Effective verbal and written skills.
• Knowledge of major insurance carrier reimbursement guidelines (Medicare, Medi-Cal, Commercial Plans).
• Able to work in a fast-paced environment and adapt to changing environment.
• Strong interpersonal, communication, time management, and organizational skills required.
• Self-Starter with the ability to work independently.
• Proficient in MS Office.

Responsibilities

• Process and submit insurance claims to various payers, ensuring accuracy in coding and billing information to minimize denials and delays.
• Review patient accounts to verify correct insurance billing information, update records as necessary, and resolve discrepancies in patient balances.
• Analyze denied claims to identify denial reasons and perform follow-up actions including appeals with documentation.
• Analyze accounts receivable reports and take action to resolve repetitive denials.
• Coordinate with healthcare providers to obtain necessary medical documentation, referrals, or authorizations.
• Discuss areas needing improvement with the authorization and CMN departments and offer solutions.
• Engage directly with patients to explain bills, resolve inquiries, and set up payment plans.
• Engage in written communication and schedule meetings with payers to address aging balances.
• Compile and submit projects to insurance companies.
• Meet with Revenue Cycle Supervisor and Director to discuss areas of concern.
• Answer questions and provide solutions to RCM team.
• Support auditors responsible for production/quality of global team members.

Skills

Customer service

Verbal and written communication

MS Office

Interpersonal skills

Time management

Organizational skills

Knowledge of insurance reimbursement

Education

High school diploma or equivalent

Tools

MS Office

Job description

Stance Health Solutions, Inc is seeking a Revenue Cycle Coordinator to manage the end-to-end revenue cycle, including claims submission, denial follow-up, and payer communications. The role requires collaboration with internal teams and external payers to optimize cash flow.

The candidate will review insurance billing information, resolve discrepancies, and support global teams with QA and process improvements. Strong MS Office skills and healthcare billing knowledge are essential.