revenue cycle management specialist

Aspen Dental

<div>The Aspen Group (TAG) is one of the largest and most trusted retail healthcare business support organizations in the U.S. and has supported over 20,000 healthcare professionals and team members with close to 1,500 health and wellness offices across 48 states in four distinct categories: dental care, urgent care, medical aesthetics, and animal health. Working in partnership with independent practice owners and clinicians, the team is united by a single purpose: to prove that healthcare can be better and smarter for everyone. TAG provides a comprehensive suite of centralized business support services that power the impact of five consumer-facing businesses: Aspen Dental, ClearChoice Dental Implant Centers, WellNow Urgent Care, Chapter Aesthetic Studio, and AZPetVet. Each brand has access to a deep community of experts, tools and resources to grow their practices, and an unwavering commitment to delivering high-quality consumer healthcare experiences at scale.
As a reflection of our current needs and planned growth we are very pleased to offer a new opportunity to join our dedicated team as a Revenue Cycle Management Specialist.
Essential Responsibilities<ul><li>
RCM Specialists care for the people who care for our patients by performing insurance adjudication, customer service, and patient collection job functions that require superior service and attention to detail.</li><li>
Bring better care to the front lines by supporting the execution and achievement of functional areas and company goals.</li><li>
Partners with internal departments to resolve issues related to all tasks and assignments supporting the business.</li><li>
Point of contact for internal and external customer inquiries, which entails contacting insurance companies and/or addressing patient inquiries.</li><li>
Uses software and company systems to source, obtain, process, audit and analyze standard data reporting and presenting.</li><li>
Plans, organizes, and executes tasks and activities with urgency and in accordance with managers&rsquo; delegated assignments.</li><li>
Responds to and resolves issues related to claim adjudication, patient and billing inquiries, while seeking managers guidance for non-routine inquiries or escalated concerns.</li><li>
May be required to meet position related productivity and quality standards.</li><li>
Other duties as assigned.</li></ul>
Requirements/Qualifications<ul><li>
Level: High School diploma or equivalent</li><li>
Job related/Industry experience preferred</li><li>
Excellent verbal and written communication skills</li><li>
Excellent organizational and time management skills</li><li>
Excellent problem solving/analysis collaboration</li><li>
Self-motivated individual with strong attention to detail</li><li>
Leadership experience preferred</li></ul>
A generous benefits package that includes paid time off, health, dental, vision, and 401(k) savings plan with match
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Hourly pay range: $19-22/hr</div>

Revenue Cycle Management Specialist

Agnite Health LLC

Agnite Health LLC is a progressive, innovative ophthalmology billing company and is in immediate need of experienced ophthalmic billers. Experience preferred with key PM systems: Nextech Select, Nextech Practice +, OpenPM, AdvancedMD, ModMed, and NextGen.Role DescriptionThis is a full-time, remote position for an Ophthalmology Billing Specialist. Responsibilities include overseeing the revenue cycle management process; such as posting payments, charges, working denials, actively working with carriers to ensure timely and accurate payment processing, helping patients understand statements, while maintaining communication with clients and team members.Excellent company, starting salary based on experience, great benefits and working conditions.Qualified individuals with ophthalmology billing and coding experience should apply.QualificationsIdeal candidates will be highly motivated, self-directed and dedicated to the successful completion of all billing and collection goals. At least 2 years&rsquo; experience in ophthalmology billing, coding and collections preferred.<ul><li>Proficiency in the Billing Process with strong attention to accuracy and detail</li><li>Experience in Client Billing and ensuring compliance with relevant billing standards</li><li>Understanding of Accounting principles and ability to work with financial data</li><li>Excellent Communication skills for collaborating with team members and interacting with clients</li><li>Proficient in billing systems and related software tools</li><li>Ability to manage multiple tasks efficiently and meet deadlines</li><li>Prior experience in ophthalmology billing or healthcare billing is a plus</li><li>High school diploma or equivalent; additional certifications in billing or accounting are favorable</li></ul>Job Type: Full-timePay: $20.00 - $24.00 per hourBenefits:<ul><li>401(k)</li><li>Dental insurance</li><li>Flexible spending account</li><li>Health insurance</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Experience:<ul><li>ophthalmology: 2 years (Required)</li></ul>Work Location: Remote

Ophthalmic Revenue Cycle Management (RCM) Specialist

CSR SERVICES LLC

Medical Billing Specialist (US Healthcare)Location: Gulberg, LahoreJob Type: Full-TimeShift: 5:00 PM &ndash; 2:00 AMExperience Required: 4&ndash;5 YearsJob SummaryWe are seeking an experienced Medical Billing Specialist with 4&ndash;5 years of hands-on experience in US healthcare billing and Revenue Cycle Management (RCM). The ideal candidate will have a strong understanding of the complete medical billing lifecycle, including insurance verification, claims submission, denial management, accounts receivable follow-up, and payment posting.Key Responsibilities<ul><li>Process and submit medical claims accurately to insurance companies.</li><li>Manage the complete Revenue Cycle Management (RCM) process.</li><li>Verify patient insurance eligibility and benefits.</li><li>Follow up on unpaid, denied, or rejected insurance claims.</li><li>Investigate and resolve claim denials and payment discrepancies.</li><li>Post insurance and patient payments and reconcile accounts receivable.</li><li>Prepare and submit appeals for denied claims.</li><li>Communicate with insurance companies regarding claim status and payment issues.</li><li>Maintain accurate patient and billing records within EMR/EHR systems.</li><li>Work closely with physicians, clinics, and healthcare providers to resolve billing issues.</li><li>Analyze billing reports to identify opportunities for improving collections and reducing denials.</li><li>Ensure compliance with HIPAA regulations and healthcare billing standards.</li></ul>Required Qualifications<ul><li>4&ndash;5 years of experience in US Medical Billing.</li><li>Strong knowledge of CPT, ICD-10, and HCPCS coding systems.</li><li>Experience with Medicare, Medicaid, Commercial, and Private Insurance claims.</li><li>Hands-on experience with Revenue Cycle Management (RCM).</li><li>Strong background in claim submission, denial management, appeals, and accounts receivable follow-up.</li><li>Experience using EMR/EHR systems and medical billing software.</li><li>Excellent communication, analytical, and problem-solving skills.</li><li>Ability to manage multiple priorities while maintaining a high level of accuracy.</li><li>Ability to work independently and meet productivity targets.</li></ul>Job Type: Full-timeApplication Question(s):<ul><li>What is your Expected Salary?</li><li>Have you worked as Medical Billing Specialist in Medical Billing Services?</li></ul>Work Location: In person

Medical Billing Specialist

HealthRev Partners

<div>Job Summary: 
The RCM Specialist for Home Health &amp; Hospice plays a crucial role in ensuring the efficient and accurate processing of claims and patient accounts, contributing to the organization's financial health. They possess a comprehensive understanding of revenue cycle processes and demonstrate expertise in resolving complex claims and patient billing issues. 


Essential Duties and Responsibilities:
<ul>
<li>Lead and optimize the full revenue cycle process from billing the claim to final payment collection.</li>
<li>Collaborate with the RCM team to maintain a clean and compliant revenue cycle.</li>
<li>Generate claims accurately from EMR system to clearinghouse and monitor the claim following HRP standard protocol.</li>
<li>Resubmit claims corrected as needed and communicate issues that need to be resolved.</li>
<li>Communicate unbilled and billed claim holds to Team Leader or RCM Manager.</li>
<li>Analyze and resolve complex claims denials and appeals.</li>
<li>Investigate and address patient billing discrepancies and disputes.</li>
<li>Identify and implement strategies to improve revenue cycle performance as needed.</li>
<li>Collaborate with cross-functional teams to implement and manage assigned RCM accounts.</li>
<li>Participate in revenue cycle audits and compliance reviews (quality review checks).</li>
<li>Develop and maintain accurate and up-to-date documentation of all claims and patient accounts.</li>
<li>Provide training and support to other RCM team members.</li></ul> 


Key Performance Indicators (KPIs):
<ul>
<li>Clean claim rate &gt;95%</li>
<li>Aged AR &lt; 20% of total AR</li>
<li>Meets productivity expectation of 45 non-Medicare claims per day or 75 Medicare</li>
<li>Net collection rate of &gt;95%</li>
<li>Meets and passes 100% of quality review checks completed by RCM Manager</li></ul> 


Qualifications:
<ul>
<li>3&ndash;5 years of experience in revenue cycle management in the home health and hospice realm</li>
<li>Proficient in Microsoft Office Suite 365</li>
<li>Proficient in home health and hospice electronic health records (EHR) systems</li>
<li>Strong understanding of insurance billing and coding procedures</li>
<li>Excellent communication, problem-solving, and analytical skills</li>
<li>Ability to work independently and as part of a team</li>
<li>Proven track record of success in resolving complex claims and patient billing issues</li></ul> 


Benefits:
<ul>
<li>Competitive salary and comprehensive benefits package, including health insurance, dental insurance, vision insurance, paid time off, and 401k savings plan</li>
<li>Opportunity to work in a dynamic and growing healthcare organization</li>
<li>Professional development and training opportunities</li>
<li>Contribution to the organization's financial success and patient satisfaction</li></ul></div>

RCM Specialist- Home Health and Hospice

Dena Frawley Consultants, LLC

Pay: $17.00 - $20.00 per hourJob description:Overview Dena Frawley Consultants, LLC provides insurance billing services to specialty healthcare practices. We are seeking a detail-oriented Billing Specialist to join our revenue cycle management (RCM) team for chiropractic and physical therapy billing services. The ideal candidate will have a strong background in medical billing and revenue cycle management. This position starts as a part-time or contract position with the possibility of becoming full-time. Thank you in advance for applying and for considering the opportunity to grow with us!Duties - Utilize various systems to process medical billing and collections- Review and analyze medical remittances for accurate payment- Update account balances- Enter insurance and financial data into patient accounts- Call insurance carriers to verify patient benefit and claim information- Request treatment authorizations from insurance companies- Resolve unpaid claims through appeals to insurance carriers- Collaborate with team members on special projects- Ensure compliance with HIPAA, ICD-10 and other coding standardsSkills - Excellent verbal and written communication skills- Organized, detail-oriented and consistent work performance- Strong attention to detail and accuracy in processing billing information- Works well autonomously and as part of a team- Proficient in Microsoft Office/365 applications- Thorough, follows through with tasks and receives direction wellExperience - Prior work in medical billing, coding, and collections- Proficiency in utilizing medical billing software and systems- Knowledge of ICD-10 coding standards- Familiarity with medical terminology and procedures- Familiarity with navigating through insurance websites and internet databases- Experience in chiropractic and physical therapy billing a plus but not requiredRequired - Strong attention to detail- Follows directions well- Works well independently in an office setting- Strong data entry capabilities- Professional phone etiquette- Internet database capabilities- Strong computer skills- Position is part-time, in a professional office setting, with occasional front desk coverage as well as in-person meetings with team members around New Haven and Fairfield counties.Job Types: Part-time, ContractApplication Question(s):<ul><li>Are you located in Connecticut?</li></ul>Work Location: In personPay: $17.00 - $20.00 per hourWork Location: Hybrid remote in Stratford, CT 06614

RCM Billing Specialist

US Anesthesia Partners

<div>Overview
:
<div></div><div>
The Billing Specialist II &ndash; RCM utilizes knowledge of insurance regulations, health insurance contracts, medical coding, and bookkeeping to perform a variety of revenue cycle support activities. These include but are not limited to medical coding, insurance verification, ensuring the accuracy of the information housed in the practice management system, preparing deposits, collecting, posting, and managing account payments, submitting accurate claims, and following up on accounts.</div><div></div><div> 
At this time, US Anesthesia Partners does not hire candidates residing in California, Hawaii, or Alaska.</div><div></div><div> 
The base pay estimate for this role is $16.49 - $26.39 hourly. The final offer will depend on the skills, experience, and qualifications of the selected candidate. This range is for base pay only and does not include bonuses or other compensation. This position is eligible for a quarterly bonus. Bonuses are not guaranteed and are awarded based on company and individual performance.</div>
Job Highlights
:
<div>
ESSENTIAL DUTIES AND RESPONSIBILITIES: (The ideal candidate must be able to complete all physical requirements of the job with or without a reasonable accommodation)</div> 
<div></div><ul><li>
Maintains the practice management system by entering accurate data, verifying and updating insurance and claims information, handles carrier correspondence, manages EOBs, and keys payments received into the system.</li><li>
Prepares, reviews, submits, and follows up with clean claims to various companies/individuals.</li><li>
Collects, posts, and manages patient account payments.</li><li>
Investigates rejected claims to see why denials were issued and correct claims.</li><li>
Facilitates swift payment of invoices due to the organization by sending patient invoices, billing reminders, and making collection calls on outstanding balances as directed by the supervisor.</li><li>
Reviews and provides RCM weekly and monthly reports including productivity and financial reports as directed and completed action steps as necessary.</li><li>
Follows HIPAA guidelines when accessing and sharing patient information.</li><li>
Maintains patient and business confidentiality.</li><li>
Provides timely and professional customer service, verifies discrepancies by and resolves patient billing issues, and answers questions from patients, facility staff, and third-party vendors.</li><li>
Supports additional coding, billing, and practice management projects as needed.</li><li>
All other duties as assigned.</li></ul>
Qualifications
:
<h2 class="jobSectionHeader">KNOWLEDGE/SKILLS/ABILITIES (KSAs):</h2><ul><li>
Highschool graduate or equivalent.</li><li>
Minimum three years of billing experience.</li><li>
Minimum one year of Healthcare experience preferred.</li><li>
Knowledge of revenue cycle processes, medical insurance, and general accounting principles.</li><li>
High degree of accuracy and attention to detail.</li><li>
Ability to manage multiple tasks/projects, and deadlines simultaneously and to identify and resolve exceptions and to interpret data; proficient in data entry.</li><li>
Excellent communication skills, both verbal and written.</li><li>
Proficient computer skills, including Microsoft Office applications.</li><li>The physical demands described here are representative of those that may need to be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.</li></ul><ul><li>
Occasional Standing</li><li>
Occasional Walking</li><li>
Frequent Sitting</li><li>
Frequent hand, finger movement</li><li>
Use office equipment (in office or remote)
</li><li>Communicate verbally and in writing</li></ul><div></div><div> 
US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.</div></div>

Billing Specialist II - Remote

Surgical Management Professionals

General Requirements&middot; Knowledge of managed care contracting, payer reimbursement methodologies, and healthcare revenue cycle operations.&middot; Strong analytical skills with the ability to interpret financial, operational, and payer data.&middot; Advanced proficiency with Microsoft Excel, including pivot tables, formulas, data validation, lookups, and data analysis functions.&middot; Experience creating dashboards, reports, and data visualizations using Microsoft Power BI or similar business intelligence platforms.&middot; Ability to analyze large datasets, identify trends, and communicate findings to operational stakeholders.&middot; Excellent written and verbal communication skills with a professional approach.&middot; Ability to work independently while effectively collaborating within a cross-functional team environment.&middot; Strong organizational skills with the ability to manage multiple priorities, meet deadlines, and maintain accuracy under pressure.&middot; Ability to promote teamwork, accountability, and continuous improvement.&middot; Regular work attendance.Job Duties and ResponsibilitiesManaged Care Contracting andRCM Optimization&middot; Establish payer relationships, subscribe to payer newsletters/bulletins in order to keep Revenue Cycle and Managed Care team apprised of network policy changes, etc.&middot; Ensure loading of contractual information, including payor fee schedules, crosswalks, and rate increases into shared sites &amp; software, as well as contract routing for signature process, logging &amp; tracking.&middot; Provide procedure pricing for all facilities.&middot; Develop and maintain contracting tools for use by Business Office staff to include summary of contracts, applicable fee schedules, grouper listings, etc. on SharePoint.&middot; Research and update state and federal fee schedules for loading into all systems, as needed.&middot; Investigate and assist in contract reimbursement issues.&middot; Maintain and update payor mapping to connect contract data with patient accounting data.&middot; Perform Single Case Agreement reviews.&middot; CDM pricing updates annually &amp; as needed provided to Revenue Cycle &amp; Price Transparency Tool.&middot; Loads contracts and other key documentation into appropriate systems (i.e., SharePoint, Cabinet).&middot; Respond to questions from sites and billing teams on contract/reimbursement issues.&middot; Additional duties as assigned within Managed Care.Healthcare Data Analytics &amp; Reporting<ul><li>Extract, analyze, and interpret healthcare data from multiple systems including HST Pathways, EPIC, patient accounting platforms, payer systems, and internal reporting tools.</li><li>Develop recurring reports and dashboards to monitor:</li><li>payer performance</li><li>reimbursement trends</li><li>payment variance</li><li>revenue opportunities</li><li>operational performance</li><li>Perform data validation, reconciliation, and quality checks to ensure reporting accuracy.</li><li>Translate data into meaningful insights for leadership and operational teams.</li></ul>&middot; Analyzes facility and payer data for new and current service lines for reimbursement opportunities.&middot; Support development of standardized reporting tools and analytics processes.Technology &amp; Analytics <ul><li>Microsoft Power BI</li><li>Build and maintain dashboards and reporting tools</li><li>Create KPI visualizations and performance scorecards</li><li>Analyze payer trends, reimbursement performance, and revenue opportunities</li><li>Develop automated reporting solutions to support leadership decision-making</li><li>Microsoft Excel (Advanced)</li><li>Pivot tables</li><li>Advanced formulas and functions</li><li>Data modeling</li><li>Large dataset management</li></ul>Work Experience Requirement2&ndash;4 years of experience in healthcare, preferably in managed care, revenue cycle management, or a related field. Advanced proficiency in Microsoft Excel, including experience working with large datasets, data analysis, and reporting. Experience in using Microsoft Power BI or similar business intelligence/reporting tools to develop dashboards and reports. Strong verbal and written communication skills with the ability to present data-driven insights effectively. Demonstrated ability to work collaboratively in a team-oriented environment. Experience with SharePoint is preferred.Education RequirementHigh School Diploma or equivalent, post-secondary education preferred.Pay: $23.00 - $29.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Flexible spending account</li><li>Health insurance</li><li>Health savings account</li><li>Life insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: Remote

Managed Care Analytics Coordinator

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