Summary: The Revenue Cycle Specialist works within the billing arm of the Revenue Cycle team, satisfying the following tasks and requirements with the responsibility of understanding and working Accounts Receivable for assigned programs to payment and completion. This includes pre and post AR review, follow up, and auditing of account accuracy, assessing collectable versus non-collectable accounts, credits, and pre billing assessment while consistently working with peers, managers, funders, and operations.

Essential Duties and Responsibilities:

Ability to time manage, pull reporting, and maintain consistent AR work in a remote setting. Position reviews charge data entry for accuracy to bill clean claims and works with other internal department to troubleshoot and resolve outstanding service and claims errors. Performs daily compressive follow up on billed claims for rejections, denials, payment, rebilling, and reprocessing to ensure timely and accurate payments from contracted and non-contracted insurance payers. Research and resolve incorrect payments following account to final compliant reconciliation and perform appropriate adjustments to accounts where relevant in post payment review. Answer patient inquiries by phone regarding outstanding account balances and insurance guidelines. Updates and maintain patient demographics and other information as needed in the EMR to ensure full account accuracy while maintaining strictest confidentiality adhering to all HIPAA guidelines. Work routine correspondence; performs in office functions as necessary and is available to the supervisor to perform other duties as assigned.

Supervisory Responsibilities

None

Required Qualifications

Education, Licensure, & Experience

HS diploma with 3 or more years healthcare billing experience. Post-secondary education preferred. Medical billing, Coding, and/or Revenue Cycle Certifications preferred. Proficiency in Microsoft Word and Excel. Proficiency in Smart sheet.

Job Knowledge, Skills, and Abilities

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Abilities include: understanding of mathematics, data entry and troubleshooting, Electronic Medical Records navigation and billing functions within, can work effectively and professionally with internal departments, external vendors, and insurance companies, understanding of payer sources and claims are processed and pay for each, including timely filing limits. Ability to effectively navigate clearinghouses, internal databases, and payer portals. Has strong customer service, verbal and written communication skills, and personal time management with goal setting. Maintains strict confidentially and works well individually and on a team.

Work Environment

The noise level in the work environment is usually moderately quiet & indoors. This position will require local travel. This position will be scheduled based on operational need & will be required to provide own transportation. Incumbent may be exposed to virus, disease, and/or infection from clients in the work environment. Incumbent may be exposed to traumatic situations (i.e. psychiatric).

Total Rewards:

• Medical, Dental, and Vision Insurance
• Flexible Spending Accounts
• Life Insurance
• Paid Time Off
• 401(k) with Company Match
• Tuition Reimbursement
• Employee Recognition Programs
• Referral Bonus opportunities
• And More!

Pyramid CORE Values:

We are committed and proud to live our CORE values and use them to inspire those around us. Our employees are expected to align with these values, behaviors and standards. We are held accountable for upholding these CORE Values: INTEGRITY is striving to be honest, transparent and ethical when dealing with clients, staff and the community. DEDICATION is demonstrating an unwavering commitment to always provide exceptional care and support to those we serve is needed daily. COLLABORATION is a steadfast, team-focused approach; working together to achieve excellence. PASSION is genuine, compelling and relentless desire to improve lives and support Pyramid Healthcare’s mission.

Want to know more?

To learn more about Pyramid Healthcare, and how you can achieve personal and professional growth, visit us at: https://bit.ly/Pyramid-Careers.

Pyramid Healthcare, Inc. is proud of its diverse workforce, and is an Equal Opportunity Employer.

Education

• High School/GED or better