Revenue Cycle Specialist (Remote)

Proliance Surgeons; Seattle, Northern (WA, KY); Hybrid; USD 52,000 - 70,000; Full time

Job summary

Proliance Surgeons is seeking a remote Revenue Cycle Specialist to oversee charge entry, billing, claims and AR tasks. The role handles patient and insurer payments, credit resolutions, and adherence to policies. Requires 1–2 years medical billing experience, CPC or equivalent certification, and familiarity with NextGen/Amkai systems.

The position is full-time, remote, with typical daytime hours, and a strong emphasis on accuracy, HIPAA compliance, and teamwork within the Revenue Cycle team.

Qualifications

• High school diploma or GED required.
• 1–2 years of medical billing experience preferred.
• CPC or equivalent certification preferred.
• Orthopedic coding experience is a plus.
• Experience with NextGen and Amkai Billing Systems preferred.

Responsibilities

• Verify information for claims before billing.
• Review surgical coding for accuracy before billing.
• Process primary, secondary and tertiary claims and address edits or rejections.
• Post patient and insurance payments.
• Handle credit resolution for insurance and self-pay credits.
• Manage accounts receivable for insurance and patient accounts.
• Process bad debt and respond to phone inquiries.

Skills

Medical billing

Claims processing

Customer service

HIPAA knowledge

Office software

Education

High School diploma or GED

1-2 years medical billing experience

CPC or equivalent certification

Orthopedic Coding experience

NextGen Billing Systems

Amkai Billing Systems

Tools

NextGen

Amkai Billing Systems

Job description

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.

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.