Revenue Cycle Specialist II

Aegis Sciences Corp; Brooklyn Heights (TN); On-site; USD 65,000 - 85,000; Full time

Job summary

Aegis Sciences Corporation is seeking a Revenue Cycle Specialist II to analyze and optimize financial processes within a healthcare setting in the Greater Nashville area. You will handle patient registration, coding, claims submission, and collections, while focusing on accuracy and timely payments.

Ideal candidates bring strong ICD9/ICD10/CPT/HCPCS knowledge, proficiency with MS Office, and experience mentoring others in a fast-paced environment.

Qualifications

• High School diploma or GED required; higher degrees preferred.
• With a HS diploma, a minimum of five (5) years of revenue cycle experience in a hospital, laboratory, ambulatory surgery center, or large medical practice with a minimum of two (2) years in denials management required; With a Bachelor’s degree, a minimum of two (2) years of finance/accounting experience required.
• Knowledge of ICD9, ICD10, CPT, and HCPCS coding strongly required.
• Strong working knowledge of Microsoft Office, including Excel and Outlook.
• Ability to take direction and follow Standard Operating Procedures with a high degree of accuracy.
• Strong attention to detail and the ability to work in a fast-paced, team-oriented environment with a focus on communication required.
• Demonstrated ability to lead initiatives and mentor others.

Responsibilities

• Analyze and optimize the financial processes within a healthcare organization, including patient registration, billing, coding, claims submission, and collections.
• Collaborate with Revenue Cycle Business Analysts and Revenue Cycle Financial Analysts.
• Review and process complex Medical Records Requests for accuracy and completeness.
• Submit carrier appeals and reconsideration requests per SOPs; suggest SOP improvements.
• Verify and upload all relevant claims and appeal documentation into OnBase.
• Mentor and train new team members; lead small-scale process improvement projects.

Skills

Medical coding

MS Office

Attention to detail

Leadership

SOP compliance

Communication skills

Education

High School diploma or GED

Associate’s or Bachelor's degree in Business, Finance, or related discipline preferred

Tools

Excel

Outlook

Microsoft Office

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

Revenue Cycle Specialist II

Full Time, Regular Professional Nashville, TN, US

10 days ago Requisition ID: 6377

The Revenue Cycle Specialist II is responsible for analyzing and optimizing the financial processes within a healthcare organization, including patient registration, billing, coding, claims submission, and collections, by identifying areas for improvement, monitoring key performance indicators (KPIs), and implementing strategies to maximize revenue while adhering to compliance regulations; essentially acting as a data-driven expert to streamline the revenue cycle and ensure accurate and timely payments from insurance companies and patients.

Candidates must reside in the Greater Nashville area.

• Work closely with Revenue Cycle Business Analysts and Revenue Cycle Financial Analysts working claims not limited to but including the following:
  • Prepare Complex Medical Records Request and review documents for accuracy, completeness, and congruency
  • Interpret Payer Correspondence and determine next appropriate action
  • Submit carrier appeals and reconsideration requests in a timely manner based on SOPs or make suggestions to enhance SOP’s
  • Review and update line-item receipt posting (LIRP) as needed or other posting needs.
  • Work assigned hold codes and determine next actions including, but not limited to, Bad Addresses, Eligibility, and other denial reasons.
  • Maintain accurate tracking of client and referring provider documentation and obtain any missing documentation to ensure accuracy and completeness
  • Ensure all relevant claims and appeal documentation is uploaded into OnBase
  • Verify all identified insurance carriers for policy related to prior authorization requirements as needed for claims adjudication
  • Work collaboratively with other Coding, Billing, Patient Access, and Cash Receipts Specialists as needed
• Mentor and train new team members
• Lead small-scale projects focused on process optimization

Successful Candidates Must Possess:

• High School diploma or GED required; Associate’s or Bachelor’s Degree in Business, Finance, or related discipline preferred
• With a High School diploma, a minimum of five (5) years of experience performing revenue cycle processes in a hospital, laboratory, ambulatory surgery center, or large medical practice with a minimum of two (2) years in denials management required; With a Bachelor’s degree, a minimum of two (2) years of finance/accounting experience required
• Knowledge of ICD9, ICD10, CPT, and HCPCS coding strongly required
• Strong working knowledge of Microsoft Office, including Excel and Outlook
• Ability to take direction and follow Standard Operating Procedures with a high degree of accuracy
• Strong attention to detail and the ability to work in a fast-paced, team-oriented environment with a focus on communication required
• Demonstrated ability to lead initiatives and mentor others

Aegis Sciences Corporation is an Equal Opportunity Employer