Revenue Cycle Specialist (Remote)

Proliance Surgeons; Rhode Island; Remote; USD 42,000 - 66,000; Full time

Job summary

Proliance Surgeons seeks a remote Revenue Cycle Specialist Assistant to support bill processes, posting payments and managing patient and insurance accounts receivable. This role requires handling charge entry, claims, credits and denials while maintaining HIPAA compliance, and delivering excellent service to patients and providers.

The position is full-time, primarily remote with standard business hours; candidates must reside in eligible states and be able to work PST hours.

Qualifications

• High School diploma or GED required; CPC certification preferred.
• 1–2 years medical billing experience is expected; orthopedic coding experience is a plus.
• Experience with Nextgen and Amkai Billing Systems is preferred.

Responsibilities

• Oversee bill processes including charge entry, billing, claims and patient/insurance AR.
• Post payments and handle credits, reversals, and denials; address edits and rejections.
• Communicate with patients and payors; maintain HIPAA compliance and confidentiality.

Skills

Billing knowledge

Payment posting

HIPAA compliance

Communication skills

Office software

Education

High School diploma or GED

CPC or other equivalent certification

Tools

Nextgen Billing

Amkai Billing

Microsoft Office

Job description

At Proliance Surgeons our patients come from all walks of life — and so do we. We hire and support people from diverse backgrounds, fostering growth and development to make Proliance a great place to work. Our unique experiences and perspectives help us deliver Exceptional Outcomes, Personally Delivered .

We are proud to offer a comprehensive and competitive benefit and pay package including health coverage, 401k with match and profit share, PTO and more! For further details regarding Benefits and Washington State Minimum Wage details please visit our careers page at Compensation during the offer process will be determined based on factors such as compensation structure, experience, qualifications, and internal equity. Be Part of Who We Are!

Position Summary

The role of the remote Revenue Cycle specialist is a valued member of our Revenue Cycle team. As a Revenue Cycle Specialist, you will work remotely and be responsible for overseeing bill processes including Charge entry, Billing, Claims, Patient AR and Insurance AR. You will also post payments, handle credit resolutions, along with other revenue cycle functions.

Schedule

Full-time, Monday - Friday, 8am - 5pm PST.

Applicants must reside in one of the following states to be employed with Proliance Surgeons: WA, FL, NC, AZ, ID, OH, OR, TN, TX, or RI.

Key Duties and Responsibilities

The key duties and responsibilities of the Revenue Cycle Specialist Assistant include, but are not limited to:

• Verify information for claims is correct prior to billing
• Review Surgical coding for accuracy prior to billing
• Process all Primary, Secondary, and tertiary claims and address any edits or rejections.
• Post all patient payments
• Post all Insurance and third-party payments
• Credit Resolution for both Insurance and Self pay credits
• Insurance AR
• Patient AR
• Process bad debt
• Answer phones
• Complete duties and assist others as directed
• Must follow all policies as introduced during new teammate On-Boarding, updated real-time and outlined in Teammate Handbook

Education/Experience

• High School diploma or GED
• Minimum 1-2 years medical billing experience
• CPC or other equivalent certification
• Orthopedic Coding Experience a plus
• Experience with Nextgen and Amkai Billing Systems preferred

Knowledge, Skills and Abilities

• High level of independence, adaption, and accuracy
• Ability to navigate online Payor portals and websites
• Ability to effectively use Office equipment
• Basic knowledge of Microsoft Office Word and Outlook
• Superior customer service skills
• Great interpersonal skills; demonstrating patience, composure, and cooperation; working well with all patients, physicians, and staff
• Understanding of and adherence to all safety, risk management and precautionary procedures, including the consistent respect for confidentiality (HIPAA)
• Using time efficiently, with meticulous attention to detail, accuracy, and completion
• Ability to manage multiple factors for the best result
• Resourcefulness in addressing first level problems and tenacity to see things through to solution
• Ability to remove oneself personally from given situations, remaining objective
• Able to adapt to change, delays or unexpected events while maintaining a positive mindset
• Clear oral and written communication
• Ability to provide feedback to improve performance
• Self-motivated; able to work following specific guidelines and in accordance with detailed instructions; measure self against standard of excellence, overcome obstacles and challenges with little supervision

Work Environment/Physical Demands

The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions.