Sr. Revenue Cycle Specialist, Day Shift, Ambulatory

Adventist HealthCare; 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 Short & Long-Term & Life

Paid Time Off

Retirement match after 1 year

Tuition Reimbursement

Employee Assistance Program (EAP)

Job summary

Adventist HealthCare is seeking a Sr. Revenue Cycle Specialist in the Gaithersburg, MD area. The role focuses on verifying and correcting insurance data, coding issues, and payer compliance for electronic and manual billing.

You will follow billing guidelines, contact insurers for appeals, and perform daily reconciliations to clear backlogs. Strong CPT/HCPCS/ICD-10 knowledge and high-volume processing are required.

Qualifications

• Bachelor’s or Associate degree in Finance, Business, Accounting or equivalent experience.
• Certified medical coder a plus.
• Experience with Electronic Health Records Software; eClinical Works desirable.
• Must maintain high volume processing with accuracy.

Responsibilities

• Verify and correct insurance information, charges and coding issues for electronic claims and manual billing.
• Ensure billing guidelines are followed per payer requirements.
• Contact insurance companies regarding appeals status.
• Perform daily reconciliation and elimination of billing backlogs.
• Follow up on payment errors, denials, and low reimbursements.
• Review EOBs and initiate appeals when needed.
• Demonstrate knowledge of CPT, HCPCS, ICD-10 coding related to billing.
• Handle patient billing calls and inquiries.
• Troubleshoot and report issues to management for resolution.
• Analyze trends, identify opportunities, and prioritize performance-improvement initiatives.
• Prepare routine reports on AR days, cash collections, denials, refunds, write-offs, etc.
• Coordinate with accounting for month-end financial reports

Skills

Billing accuracy

Coding knowledge

Attention to detail

Communication skills

Education

Bachelor’s/Associate degree in Finance/Business/Accounting

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-cigarettes, vaping products, hookah, and nicotine replacement products (e.g., nicotine gum, nicotine patches, nicotine lozenges, etc.).)

Equal Employment OpportunityAdventist HealthCare is an Equal Opportunity/Affirmative Action Employer. We are committed to attracting, engaging, and developing the best people to cultivate our mission-centrics culture. Our goal is to have a welcoming, equitable, and safe place to work and grow for all employees, no matter their background. AHC does not discriminate in employment opportunities or practices on the basis of race, ethnicity, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, pregnancy and related medical conditions, protected veteran status, or any other characteristic protected by law.

Adventist HealthCare will make reasonable accommodations for applicants with disabilities, in accordance with applicable law. Adventist HealthCare is a religious organization as defined under applicable law; however, it will endeavor to provide reasonable accommodations for applicants’ religious beliefs.

Applicants who wish to request accommodations for disabilities or religious belief should contact the Support Center HR Office.