Revenue Cycle Specialist – Remote

Orthonc; Pennsylvania; Remote; USD 40,000 - 80,000; Full time

Job summary

An established industry player is looking for a dedicated Revenue Cycle Specialist, Level III, to join their remote team. In this crucial role, you will manage the entire claims process, ensuring timely follow-ups and resolutions for services rendered. Your expertise will be vital in navigating insurance policies, appealing denied claims, and maintaining accurate patient billing. The company fosters a collaborative work environment and offers a competitive compensation package with comprehensive benefits. If you're passionate about healthcare billing and are ready to make a significant impact, this opportunity is perfect for you.

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Short-term Disability

Long-term Disability

Paid Holidays

Paid Time Off

Paid Training

401(k)

Qualifications

• 10+ years experience in medical billing preferred.
• Strong knowledge of insurance payer policies and CPT/Dx codes.

Responsibilities

• Resolve denials and ensure claims are processed and paid.
• Review and appeal denied claims, handle collections.

Skills

Medical Billing

Claims Processing

Insurance Payer Policies

CPT/Dx Medical Codes

Collections

Education

High School Diploma or GED

Job description

Orthopaedic Specialists of North Carolina is seeking a full-time Revenue Cycle Specialist, Level III.

This position is remote. Hours are Monday-Friday 8A-5P.

Summary/Objective:

The Revenue Cycle Specialist, Level III, is responsible for following up on claims for services rendered. The insurance company will either reject or deny the claim, wherein it will have to be corrected and resubmitted (or be written off with Manager approval) OR they will approve the claim and pay the practice; if there is a remaining balance, the Revenue Cycle Specialist, Level III, must then submit to secondary/tertiary insurance or send a bill to the patient, whichever is applicable.

Essential Functions:

1. Work assigned holds and worklist to effectively resolve denials, takebacks, and credits.
2. Work directly with the insurance company, the patient, and the healthcare provider, to get claims processed and ultimately paid.
3. Review and appeal denied and unpaid claims.
4. Call insurance companies/payers regarding any discrepancies in payments.
5. Follow insurance guidelines and policies, and CMS guidelines and rules.
6. Perform rebill projects and additional daily reports.
7. Verify patients’ insurance coverage and update claims/charts as needed.
8. Review patient bills for accuracy and completeness and obtain any missing information.
9. Handle collections and unpaid accounts by establishing payment arrangements with patients, monitoring payments, and following up with patients if or when there is a lapse in payment.
10. Get in touch with collection agencies and determine if legal options should be pursued.
11. Answer any questions patients may have about billing.
12. Act as a primary billing resource to staff.

Required Education and Experience:

• High School Diploma or GED Certificate.

Preferred Education and Experience:

• 10+ years experience in medical billing.
• Collections or accounts receivable experience.
• Strong skill set with the insurance payer policies and rules.
• Experience and knowledge with CPT/Dx medical codes.
• ASC experience.

Orthopaedic Specialists of North Carolina offers a team-oriented work environment and competitive compensation package, with full-time benefits including: health, dental, vision, life insurance, short-term and long-term disability, paid holidays, paid time off, paid training, and 401(k). Additional supplemental benefits are offered.

For more information about our company, please visit our website at www.orthonc.com. We are an equal opportunity employer.