Revenue Cycle Specialist II: A/R & Denials Expert

Aegis Sciences Corporation; Nashville (TN); Vor Ort; USD 60.000 - 76.000; Vollzeit

Zusammenfassung

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 work with Revenue Cycle teams to review complex medical records, payer communications, and denials, while ensuring timely, compliant payments and mentoring junior staff through process improvements.

Qualifikationen

• High School diploma or GED required; higher degree preferred.
• With HS diploma, 5+ years revenue cycle experience in healthcare; 2+ years in denials management.
• Bachelor's degree: 2+ years finance/accounting experience.
• Knowledge of ICD9/10, CPT, HCPCS coding strongly required.
• Strong MS Office skills, especially Excel and Outlook.
• Attention to detail and accuracy in fast-paced team environment.
• Ability to follow SOPs and take direction.
• Experience leading initiatives and mentoring others.

Aufgaben

• 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 SOPs
• 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

Kenntnisse

Coding knowledge (ICD9/ICD10/CPT/HCPCS

Attention to detail

Leadership / mentoring

Communication

Ausbildung

HS diploma or GED

Associate/Bachelor degree in Business/Finance

Tools

Microsoft Office (Excel/Outlook)

OnBase

Jobbeschreibung

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 work with Revenue Cycle teams to review complex medical records, payer communications, and denials, while ensuring timely, compliant payments and mentoring junior staff through process improvements.