Revenue Cycle Specialist - Remote

The Revenue Cycle Management Department is seeking an experienced Remote Revenue Cycle Specialist (RCS) to join our team. The successful candidate will be a motivated, resourceful professional committed to resolving each account with as few touches as possible.

The Revenue Cycle Specialist will be responsible for researching account issues, communicating with payors, identifying appropriate resolutions, and taking ownership of accounts through to final resolution. This role requires persistence, critical thinking, strong communication skills, and a willingness to ask questions and investigate until the appropriate solution is identified.

Key Responsibilities

• Manage assigned accounts from initial review through final resolution.
• Research and resolve billing, payment, denial, and reimbursement issues efficiently.
• Utilize payor portals to obtain account information, verify claim status, and research payment and denial issues.
• Prepare and submit reconsiderations, payment disputes, appeals, and other required documentation.
• Identify the root cause of account issues and determine the appropriate steps needed for resolution.
• Communicate effectively with payors and internal departments through written and verbal correspondence.
• Follow up consistently on outstanding claims, appeals, and payment disputes.
• Minimize the number of touches required to resolve each account while maintaining accuracy and thoroughness.
• Ask thoughtful questions and seek additional information when necessary to move an account toward resolution.
• Maintain accurate and timely documentation of all account activity and follow-up.
• Take ownership of assigned accounts and remain persistent until resolution is achieved or a clear action plan has been established.

Qualifications & Skills

• Previous experience in revenue cycle management, medical billing, claims, or a related healthcare financial role.
• Experience working with payor portals.
• Experience submitting reconsiderations, payment disputes, and appeals.
• Strong written and verbal communication skills.
• Excellent problem-solving and critical thinking abilities.
• Strong attention to detail and organizational skills.
• Ability to research issues independently and determine appropriate next steps.
• Persistent and resourceful approach to account resolution.
• Ability to work independently and effectively in a remote environment.
• Strong computer skills and ability to learn and navigate multiple systems.

What Makes a Successful Revenue Cycle Specialist?

A successful RCS does not simply move an account to the next step; they take ownership of the account and pursues resolution. The key is to keep asking questions, researching the issue, and identifying what needs to be done or submitted until the account is resolved or a clear path to resolution has been established.