Revenue Cycle Specialist - Lead

Catalpa Health; Appleton (WI); On-site; USD 65,000 - 80,000; Full time

Benefits offered by this job

Competitive pay

Health insurance plans (FSA & HSA)

Dental and vision insurance

Life Insurance, Critical Illness & Acc

Disability (short & long-term)

Retirement plan with company match

Dependent Care Saving Plan

Paid Time Off + 9 holidays

Education reimbursement

Wellness program

Job summary

Catalpa Health is seeking a detail-oriented Revenue Cycle Specialist - Lead to support the billing process from charge entry to payment posting. In this working Lead role, you will coordinate daily revenue cycle operations and guide team members while maintaining confidentiality of sensitive financial and patient information.

The ideal candidate will have an associates degree in healthcare administration or related field, 2+ years billing experience, and proficiency with Epic EMR and Microsoft

Qualifications

• Associates degree in Healthcare Administration, Business Administration or related field.
• 2+ years of experience in medical billing, insurance claims processing, denial management or a related healthcare revenue cycle role.
• Experience with electronic medical record software, such as Epic.

Responsibilities

• Train and guide work of revenue cycle team members.
• Enter, review, and submit accurate billing claims and invoices in a timely manner.
• Verify patient, insurance, and account information for accuracy.
• Post insurance and patient payments, adjustments, and denials.
• Review accounts receivable and follow up on outstanding balances and unpaid claims.
• Research and resolve billing discrepancies, rejected claims, and denials.
• Prepare and submit corrected claims and supporting documentation as needed.
• Communicate with insurance companies regarding claim status, payment issues, and eligibility.
• Respond to patient billing questions and assist with account inquiries in a professional manner.

Skills

Communication skills

Attention to detail

Multitasking

Insurance regulations knowledge

Analytical/problem-solving

Education

Associates degree in Healthcare Administration or related field

Tools

Epic EMR

Microsoft Office

Job description

We are seeking a detail-oriented and dependable Revenue Cycle Specialist - Lead to join our team. This position is responsible for supporting the billing and revenue cycle process from charge entry through payment posting and account follow-up. As a working Lead, you will also be responsible for coordinating and supporting daily revenue cycle operations. The ideal candidate has strong attention to detail, excellent organizational skills, and the ability to maintain confidentiality while working with sensitive financial and patient information.

Who We Are

Catalpa Health is a pediatric mental health non-profit organization serving over 7,800 children in the Fox Valley annually. Our team members work diligently to meet the needs of our clients, offering families the support they need at the right time, close to home. Our vision to inspire hope and provide world-class mental health care is our driving force and is realized each day through the actions of our team members.

Why Choose Catalpa Health

Building a supportive work environment is at the heart of our values. One way of expressing that support is by providing a comprehensive whole-person benefits plan. We believe in providing resources to our team members to support them in all stages of their life’s journey.

Benefits Of Working At Catalpa Health

• Competitive pay
• Multiple health insurance plans offering both FSA and HSA pre‑tax savings
• Dental and vision insurance plans
• Life Insurance, Critical Illness and Accident insurance
• Short & Long‑term disability
• Retirement plan with generous company match
• Dependent Care Saving Plan
• Paid Time Off, plus 9 paid holidays each year
• Annual professional development/continuing education reimbursement program
• Wellness program providing additional resources to help our team members maintain a healthy work‑life balance

Work Environment

• Day-Shift (Monday-Friday)
• Casual dress code
• Fun, supportive and dedicated staff members

Position Essential Functions And Responsibilities

• Train and guide work of revenue cycle team members
• Enter, review, and submit accurate billing claims and invoices in a timely manner
• Verify patient, insurance, and account information for accuracy
• Post insurance and patient payments, adjustments, and denials
• Review accounts receivable and follow up on outstanding balances and unpaid claims
• Research and resolve billing discrepancies, rejected claims, and denials
• Prepare and submit corrected claims and supporting documentation as needed
• Communicate with insurance companies regarding claim status, payment issues, and eligibility
• Respond to patient billing questions and assist with account inquiries in a professional manner

Preferred Education, Experience And Certification(s)

• Associates degree in Healthcare Administration, Business Administration or related field
• 2+ Years of experience in medical billing, insurance claims processing, denial management or a related healthcare revenue cycle role
• Experience with electronic medical record software, such as Epic

Skills And Abilities

• Superior verbal and written communication skills
• Attention to detail and ability to multitask
• Strong knowledge of insurance regulations, medical terminology and payer guidelines
• Strong analytical and problem‑solving abilities
• Proficient with Microsoft Office Suite, EPIC and/or related software
• Thorough understanding of applicable ethical codes and standards
• Thorough understanding of compliance measures related to HIPAA and patient health information

Catalpa Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.