Sr. Revenue Cycle Specialist, Day Shift, Ambulatory

Fort Washington Medical Center; Gaithersburg (MD); On-site; USD 36,000 - 54,000; Full time

Benefits offered by this job

Free Employee parking

Medical, Prescription, Dental, Vision

Employer-paid Disability & Life

Paid Time Off

Retirement contribution and match

Tuition Reimbursement

EAP

Job summary

Adventist HealthCare is seeking a Sr. Revenue Cycle Specialist in Gaithersburg, MD. The role focuses on verifying and correcting insurance information, charges, and coding on electronic claims while ensuring adherence to payer guidelines.

You will handle appeals, backlogs, and follow-up on denials to optimize cash collection and efficiency. The position requires strong knowledge of CPT/HCPCS/ICD-10 coding, experience with EHR systems (eClinical Works preferred), and the ability to communicate

Qualifications

• Bachelor's or Associate degree in Finance, Business, Accounting or equivalent experience; 7 years in the field.

Responsibilities

• Verify and correct insurance information, charges and coding for electronic claims and manual billing.
• Ensure billing follows payer guidelines.
• Contact insurers regarding appeals status.
• Daily reconciliation and reduction of billing backlogs.
• Follow up on payment errors and denials.
• Review EOBs and initiate appeals as needed.
• Analyze metrics to identify improvement opportunities across billing operations.
• Coordinate with accounting for month-end financial reporting.

Skills

Billing & coding

Insurance follow-up

Customer service

Accounting understanding

Education

Bachelors or Associates in Finance, Business, Accounting or equivalent

Tools

eClinical Works

Job description

Support Center

As a Sr. Revenue Cycle Specialist you will:

• Verifies and corrects insurance information, charges and coding issues for electronic claims and manual corporate billing.
• Ensures that all billing guidelines are followed per the payer billing requirements.
• Contacts insurance companies regarding status of appeals.
• Daily reconciliation and elimination of billing backlogs.
• Follow-up on payment errors, low reimbursement, denials, etc.
• Review EOBs and initiate appeals as necessary.
• Demonstrates working knowledge of coding (CPT, HCPCS, ICD-10, etc) as it relates to billing.
• Responsible for taking and resolving patient billing calls and inquiries.
• Demonstrates an ability to troubleshoot, report to management, and/or initiate resolution of all issues that occur with regard to billing operations.
• Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement in a variety of areas, including but not limited to: coding, claim submission, insurance and self-pay collections, refunds and write-off approvals.
• Routine Reporting of Key metrics include: AR days, cash collections, denials, avoidable write-offs, refunds, charge lag, bad debt, etc.
• Coordinates with accounting to ensure accurate and timely month-end financial reports

Qualifications include:

• Bachelor's or Associates degree in Finance, Business, Accounting or equivalent experience and 7 years' experience in this field.
• Certified medical coder a plus
• Experience with Electronic Health Records Software. eClinical Works experience is desirable.
• Must maintain a high volume of processing without compromising quality and accuracy.

Work Schedule:

• Employment Type: Full-time
• Hours per Week: 40 hrs/week
• Typical Daily Schedule: Monday through Friday
• Shift Type: Day
• Weekend Requirements: None
• Holiday Requirements: Follow company holiday calendar

Pay Range:
$26.00 - $39.00 If the salary range is listed as $0 or if the position is Per Diem (with a fixed rate), salary discussions will take place during the screening process.

Under the Fair Labor Standards Act (FLSA), this position is classified as:

United States of America (Non-Exempt)

At Adventist HealthCare our job is to care for you.

We do this by offering:

• Work life balance through nonrotating shifts
• Recognition and rewards for professional expertise
• Free Employee parking
• Medical, Prescription, Dental, and Vision coverage for employees and their eligible dependents effective on your date of hire
• Employer-paid Short & Long-Term Disability, Basic Life Insurance and AD&D, (short-term disability buy-up available)
• Paid Time Off
• Employer retirement contribution and match after 1-year of eligible employment with a 3-year vesting period
• Voluntary benefits include flexible spending accounts, legal plans, and life, pet, auto, home, long term care and critical illness & accident insurance
• Subsidized childcare at participating childcare centers
• Tuition Reimbursement
• Employee Assistance Program (EAP) support

As a faith-based organization, with over a century of caring for the communities in the Maryland area, Adventist HealthCare has earned a reputation for high-quality, compassionate care. Adventist HealthCare was the first and is the largest healthcare provider in Montgomery County.

If you want to make a difference in someone's life every day, consider a position with a team of professionals who are doing just that, making a difference.

COVID-19 Vaccination

Adventist HealthCare strongly recommends all applicants to be fully vaccinated for COVID-19 before commencing employment. Applicants may be required to furnish proof of vaccination.

Tobacco and Drug Statement

Tobacco use is a well-recognized preventable cause of death in the United States and an important public health issue. In order to promote and maintain a healthy work environment, Adventist HealthCare will not hire applicants for employment who either state that they are nicotine users or who test positive for nicotine and drug use.

While some jurisdictions, including Maryland, permit the use of marijuana for medical purposes, marijuana continues to be classified as an illegal drug under the federal Controlled Substances Act. As a result, medical marijuana use will not be accepted as a valid explanation for a positive drug test result.

Adventist HealthCare will withdraw offers of employment to applicants who test positive for Cotinine (nicotine) and marijuana. Those testing positive are given the opportunity to re-apply in 90 days, if they can truthfully attest that they have not used any nicotine products in the past ninety (90) days and successfully pass follow-up testing. ("Nicotine products" include, but are not limited to: cigarettes, cigars, pipes, chewing tobacco, e-cig