Revenue Cycle Specialist II

Aegis Sciences Corp; Nashville (TN); On-site; USD 55,000 - 75,000; Full time

Job summary

Aegis Sciences Corporation in Nashville, TN is seeking a Revenue Cycle Specialist II to analyze and optimize financial processes across patient registration, billing, coding, claims submission, and collections. You will identify improvement opportunities, monitor KPIs, and implement strategies to maximize revenue while ensuring compliance with regulations.

You will collaborate with Revenue Cycle Analysts, prepare complex medical records requests, interpret payer correspondence, submit appeals,

Qualifications

• High School diploma or GED required; Associate's or Bachelor's in Business, Finance, or related discipline preferred.
• With a HS diploma, five (5) years revenue cycle experience in a hospital, lab, ASC, or large practice; with a Bachelor's, two (2) years finance/accounting experience required.
• Knowledge of ICD9, ICD10, CPT, and HCPCS coding strongly required.
• Strong MS Office skills, including Excel and Outlook.

Responsibilities

• Analyze and optimize patient registration, billing, coding, claims submission, and collections processes.
• Identify improvement opportunities, monitor KPIs, and implement strategies to maximize revenue while ensuring regulatory compliance.
• Collaborate with Revenue Cycle Analysts and other specialists; mentor new team members and lead small process-improvement projects.

Skills

ICD-9/ICD-10 coding

CPT coding

HCPCS coding

Microsoft Office (Excel/Outlook)

Education

High School diploma or GED

Associate's or Bachelor's in Business/Finance

Job description

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Revenue Cycle Specialist II

Full Time, Regular Professional Nashville, TN, US

3 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.

• 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