revenue cycle specialist

Mains'l Services, Inc.

<div>Do you want to work in the business of hopes and dreams where you can make a difference in the lives of others? Do you want to work with a company that has continued to be ranked a Top Workplace? Join the Mains&rsquo;l crew on our journey to change the world and make it a better place, one person at a time. 
 
Mains&rsquo;l Services, Inc. is currently seeking a full-time Revenue Cycle Specialist to work within in our accounting team overseeing the activities necessary for our medical billing to ensure all payments owed to the company are billed and received in a timely manner. We will be hiring a person to support our CA billing. This position works closely with internal and external stakeholders to provide quality and timely customer service regarding services and claims. The CA Revenue Cycle Specialist will also have the opportunity to support a short-term project building our fee-billing system for ongoing stability. 
 
Mains&rsquo;l is committed to providing Equal Employment Opportunities to all employees and applicants. 
 
Benefits: Health, Dental, Life, 401(k), Paid Time Off, Parental Leave, Education Assistance, along with a flexible and supportive work environment. 
 
Salary: $53,539.20-$60,798.40 annually 
 
Work schedule: Monday to Friday 8:30am-5pm Hybrid 
 
Job Duties Include:<ul><li>
Enter service authorizations</li><li>
Maintaining company record keeping standards</li><li>
Creating reports to ensure submitted claims are accurately billed</li><li>
Print and enter service authorizations</li><li>
Check eligibility for stakeholders</li><li>
Partner with internal and external stakeholders in regard to authorizations, eligibility, payroll discrepancies, and billing errors as needed</li><li>
Coordinate with the Accounting Manager to perform account reconciliation between the General Ledger and billed services</li><li>
Post payments to accounts</li><li>
Follow up on outstanding aged accounts</li><li>
Data Entry</li><li>
Coordinate with External stakeholders to ensure Services Authorizations are accurate for reimbursement</li><li>
Coordinate with our systems vendor for any fixes, changes or improvements that are needed for billing</li></ul>
Qualifications/Skills:<ul><li>
Bachelor&rsquo;s degree in an Accounting related field, or equitable experience is preferred</li><li>
2-3 years of experience in Accounts Receivable</li><li>
1-2 years of medical billing experience, preferred</li><li>
Technical computer experience, especially in Excel</li><li>
A strong desire to learn and collaborate in a team friendly atmosphere</li><li>
Innovative, looking for system enhancements and process improvements</li><li>
Effective communicator, both oral and written</li><li>
Inclusive with stakeholders and employees, ensuring their needs and expectations are met</li><li>
Flexible, able to adapt to changing roles, responsibilities, and environment</li><li>
High level of integrity for maintaining confidentiality of employees and the people we serve</li><li>
High level of attention to detail</li></ul>
Please visit our website at http://www.mainsl.com to apply online.
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Revenue Cycle Specialist

Active Hires USA

Job Title: Revenue Cycle Management (RCM) SpecialistLocation: Egypt (Work from Home)Company: Go Physical Therapy (USA-based)Job Type: Full-time (Remote, Work from Home)About Us:Go Physical Therapy is a leading physical therapy provider based in the USA, committed to delivering exceptional care to our patients. We are seeking a skilled and experienced RCM Specialist to join our team remotely from Cairo, Egypt. This role is crucial in ensuring the smooth management of our revenue cycle and optimizing our billing processes.Job Overview:As an RCM Specialist, you will be responsible for managing the end-to-end revenue cycle, including patient registration, insurance verification, claim submission, and payment posting. You will collaborate with our team in the USA to ensure timely and accurate billing, minimize claim denials, and improve overall revenue collection. This position offers the flexibility of working from home, allowing you to balance your professional and personal life effectively.Key Responsibilities:<ul><li>Insurance Verification: Confirm patient insurance coverage and eligibility prior to services being rendered.</li><li>Billing &amp; Coding: Ensure accurate coding of medical services and procedures to maximize reimbursement.</li><li>Claim Submission: Prepare and submit claims to insurance companies and other payers efficiently.</li><li>Follow-Up: Track and follow up on unpaid claims, resolving issues related to claim denials or rejections.</li><li>Payment Posting: Accurately post payments from insurance companies and patients to the correct accounts.</li><li>Reporting: Generate and analyze reports related to revenue cycle metrics, such as days in accounts receivable, denial rates, and collection efficiency.</li><li>Compliance: Ensure that all billing practices comply with relevant regulations and industry standards.</li></ul>Qualifications:<ul><li>Experience: Minimum of 1-2 years of experience in revenue cycle management or medical billing.</li><li>Skills:</li><li>Strong understanding of medical billing, coding (ICD-10, CPT), and insurance processes.</li><li>Proficiency in healthcare management software (e.g., EMR/EHR systems).</li><li>Excellent communication and problem-solving skills.</li><li>Ability to work independently and manage multiple tasks effectively.</li><li>Fluency in English: Both written and spoken fluency in English is required to effectively communicate with our USA-based team and clients.</li><li>Soft Skills: Teamwork, adaptability, and attention to detail are highly valued.</li></ul>What We Offer:<ul><li>Competitive salary</li><li>Opportunity to work remotely from home in Egypt</li><li>Professional development and growth opportunities</li><li>A collaborative and supportive work environment</li></ul>Job Type: Full-timePay: E&pound;10,000.00 - E&pound;18,000.00 per monthExperience:<ul><li>Revenue Cycle Management Specialist: 1 year (Required)</li></ul>Language:<ul><li>English (Required)</li></ul>

Revenue Cycle Management (RCM) Specialist - remotely

IGarner System

Job Opportunity: Dental Billing Specialist Cyber System Medical Billing - Now Hiring Onsite!Location: Mozang, 03 Fane RoadAre you an experienced and meticulous Dental Billing Specialist with exceptional English communication skills? Join the dedicated team at Cyber System Medical Billing and help us ensure accurate and timely revenue cycles for our dental clients! This is a full-time, onsite position.The Role: Dental Billing SpecialistAs a Dental Billing Specialist, you will be crucial in managing the complete billing cycle for our US-based dental practices. Your primary focus will be on maximizing collections, minimizing claim denials, and ensuring compliance.Key Responsibilities:<ul><li>Claim Submission: Prepare, review, and submit dental claims (ADA codes) accurately and promptly to various insurance carriers (PPOs, HMOs, etc.).</li><li>A/R Follow-up: Aggressively follow up on outstanding claims, appeals, and denials via phone and online portals.</li><li>Payment Posting: Accurately post insurance and patient payments, adjustments, and denials.</li><li>Verification: Perform detailed insurance eligibility and benefits verification for scheduled procedures.</li><li>Communication: Liaise effectively with insurance company representatives and internal teams, often requiring complex explanation and negotiation.</li><li>Reporting: Generate reports on billing activities, collection rates, and denial trends.</li></ul>Required Qualifications:<ul><li>Prior Experience is a Must: Proven, verifiable experience as a Dental Billing Specialist or similar role in the healthcare/medical billing sector.</li><li>Exceptional English Speaking Skills: Mandatory requirement for clear, professional, and effective communication with US contacts.</li><li>Dental Coding Proficiency: Deep knowledge of coding, dental terminology, and standard dental billing practices.</li><li>Onsite Commitment: Must be available to work full-time, onsite at our Mozang, 03 Fane Road office.</li><li>Technical Skills: Proficient with dental practice management softwares</li><li>Detail-Oriented: Excellent organizational skills and attention to detail to ensure billing accuracy.</li></ul>Why Join Cyber System Medical Billing?<ul><li>Competitive salary package.</li><li>Stable, professional, and supportive work environment.</li><li>Opportunity to be part of a growing company in the revenue cycle management industry.</li></ul>Job Type: Full-timePay: Rs80,000.00 - Rs100,000.00 per monthWork Location: In person

Dental Billing Specialist

MaxRemind

Job Title: Medical Billing SpecialistJob Description: We are looking for a Medical Billing Specialist with experience in medical billing and claims processing. The ideal candidate will be responsible for preparing and submitting claims, verifying insurance, resolving denials, and ensuring compliance with payer and HIPAA requirements. This role requires strong attention to detail, knowledge of coding and billing practices, and effective communication skills to coordinate with patients, providers, insurers, and internal teams.Key Responsibilities:<ul><li>Prepare, submit, and follow up on insurance claims to ensure timely reimbursement.</li><li>Verify patient insurance coverage, eligibility, and benefits.</li><li>Apply accurate CPT, ICD-10, and HCPCS codes as per payer requirements.</li><li>Resolve claim denials by coordinating with patients, providers, and insurers.</li><li>Maintain compliance with HIPAA regulations and company policies.</li><li>Collaborate with internal teams to ensure billing accuracy and support revenue cycle improvements.</li></ul>Requirements:<ul><li>Bachelor&rsquo;s degree (mandatory).</li><li>6 months &ndash; 1.5 years of experience in medical billing, claims processing, or healthcare revenue cycle.</li><li>Strong knowledge of coding, billing software, and insurance processes.</li><li>Excellent attention to detail, communication, and problem-solving skills.</li></ul>Location: Near Old Airport. Fazal Town, Rawalpindi.Onsite-JobTimings: 8AM - 5PMHow To Apply:Share your resume at [hr@mremind.com] with subject line &quot;Application for Medical Billing Specialist&quot;Job Type: Full-timePay: Rs40,000.00 - Rs50,000.00 per monthWork Location: In person

Medical Billing Specialist

Jawa Health Care

A Denials ere's Job Position Summary:The Denials Management Specialist is responsible for reviewing and resolving denied or rejected insurance claims to maximize reimbursement. This role involves analyzing denial trends, identifying root causes, and working with payers, internal departments, and appeals teams to prevent future denials and improve collection rates.Key Responsibilities:<ul><li>Review and analyze insurance claim denials and rejections.</li><li>Determine the root cause of denials and take corrective action.</li><li>Prepare and submit appeals with supporting documentation as needed.</li><li>Communicate with insurance companies to follow up on pending or denied claims.</li><li>Work collaboratively with billing, coding, and clinical teams to correct errors and resubmit claims.</li><li>Track and document denial trends, appeal success rates, and recovery efforts.</li><li>Stay current with payer policies, coding guidelines, and reimbursement procedures.</li><li>Recommend process improvements to reduce denial rates.</li><li>Meet or exceed productivity and accuracy standards.</li><li>Maintain confidentiality of patient and organization data.</li></ul>Qualifications:<ul><li>High school diploma or GED required; Associate&rsquo;s or Bachelor&rsquo;s degree preferred.</li><li>2+ years of experience in medical billing, coding, or denials management.</li><li>Strong knowledge of medical terminology, CPT, ICD-10, and HCPCS coding.</li><li>Familiarity with payer-specific denial codes and appeal processes.</li><li>Experience with billing software and Electronic Health Records (EHR) systems (e.g., Epic, Cerner, Athena).</li><li>Excellent communication and problem-solving skills.</li><li>Detail-oriented with strong organizational skills.</li></ul>Preferred Certifications:<ul><li>Certified Professional Coder (CPC)</li><li>Certified Revenue Cycle Specialist (CRCS)</li><li>Certified Medical Reimbursement Specialist (CMRS)</li></ul>Work Environment:<ul><li>Office-based or remote (depending on company policy)</li><li>May require extended periods of computer use</li><li>Fast-paced, deadline-driven</li></ul>Job Type: Full-timePay: Rs50,000.00 - Rs100,000.00 per monthWork Location: In person

Denial Management specialist

Boston Medical Center

<div>POSITION SUMMARY:
Revenue cycle management (RCM) is the financial process that makes it possible for healthcare organization to fulfil their mission of providing quality care for patients and communities. Pharmacy revenue cycle is complex process and requires a collaborative and specialized approach. Improving performance requires fine-tuned workflows, training, dedicated resources, collaboration across multiple departments, and routine updates to core systems.
Under the direction of the Revenue Cycle Supervisor Pharmacy, the Revenue Cycle Claims Specialist is responsible through extensive telephone and written correspondence, will pursue insurance companies for payment or underpayment of services rendered. Will also substantiate accurate reimbursement through correct contract terms, billing practices and compliance with state and federal guidelines. Must have the ability to analyze, audit, problem solve and reconcile an account is critical to this position. Conducts duties in accordance with industry federal and state billing guidelines and contractual obligations and in compliance with department policies and procedures.
As part of the Pharmacy Complex Claims team, we are able to bring traditional revenue cycle functions into the department of pharmacy which can provides significant opportunities for our health system. Key factors are hiring individuals with financial, pharmacy and medical revenue cycle expertise as a reimbursement solutions that identify and recover overlooked revenue for BMC.
Position: Senior Claims Analyst
Department: Pharmacy Revenue Cycle
Schedule: Full Time
ESSENTIAL RESPONSIBILITIES / DUTIES:<ul>
<li>
Research, resolve, and prepare claims that have not passed the payer edits daily. Determine and initiate action to resolve rejected drug claims.</li>
<li>Serve as subject matter expert for strategic provider relationships, service issues, reimbursement and claims.</li>
<li>Possess excellent medical and billing terminology skills; Ability to read, analyze and interpret prescription drug orders.</li>
<li>Monitor rejections on all electronic and paper claims to determine where enhancements or fixes are needed in system edits to gain efficiencies and to prevent ongoing rejections.</li>
<li>Knowledge of Medicare and third-party codes and billing procedures as well as patient billing techniques.</li>
<li>Effectively communicate issues and results via multiple media including in-person meetings, workgroups, verbal communication, email and presentations.</li>
<li>Knowledge of Medicare and other regulatory billing codes and practices in order to assess billing for accuracy prior to submission to appropriate agency or company for processing and payment. Should be well-versed in regulatory guidelines and industry standards for Medicare and/or specific payer benefit providers.</li>
<li>Collaborates with team and other revenue cycle departments to improve denials, avoidable write-offs,</li>
<li>Applies analytical skills to pre-established work processes that may require preparation of reports or documents for further review or analysis.</li>
<li>Research, analyze, and respond to inquiries regarding compliance, payor policies and guidelines, inappropriate coding, denials, and billable services</li>
<li>Follow-up on outstanding account balances at 45-days from the date of service in accordance to organizational protocol with an emphasis on maximizing client satisfaction and provider profitability</li>
<li>Utilize Hospital's Core Values as the basis for decision making and to facilitate hospital mission.</li>
<li>Must adhere to all of BMC&rsquo;s RESPECT behavioral standards.</li></ul>
(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).
JOB REQUIREMENTS
EDUCATION:
Bachelor&rsquo;s degree in Business, Healthcare or closely related field or equivalent work experience.
CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:
Certified Pharmacy Technician (Preferred)
Certified Coder CPC or RIHT (preferred)
EXPERIENCE:
5+ years of experience in healthcare, coding, finance, revenue cycle, patient accounting and/or physician billing, preferably in a Medical Center setting, Oncology or Home/Office Infusion settings.
KNOWLEDGE AND SKILLS:<ul>
<li>
Requires advanced working knowledge of professional billing flows including charge entry, editing system functionality, and revenue cycle tasks.</li>
<li>Ability to analyze and solve complex problems related to system processes and workflows.</li>
<li>Responsible to monitor and resolve Claims Work queues; Specifically, Front End, Referrals &amp; Authorizations, and Clinical Workflow.</li>
<li>Strong knowledge of claim edits NCCI (National Correct Coding Initiative (NCCI) Edits) and MUE (Mutually unlikely edits).</li>
<li>Ability to converts pharmacy drug quantities into Medicare billing units according to Medicare Guidelines prior to submitting medical CMS1500 claim forms.</li>
<li>Ensures all billable services are processed EPIC in a timely manner.</li>
<li>Superior analytical skills to critically evaluate information gathered from multiple sources and synthesize into actionable information</li>
<li>Strong interpersonal skills to elicit cooperation from a wide variety of sources, including upper management, clients, and other departments.</li>
<li>Strong interpersonal skills with attention to detail and ability to organize, interpret, and present data.</li>
<li>Must be able to present information effectively in both written and oral forms, tailoring messages to the audience.</li>
<li>Understanding and knowledge of the business, products, programs, corporate organizational structure (including functional responsibilities), and basic research principles/methodologies</li>
<li>Must have a working knowledge of (CPT/HCPCS and ICD-10-CM-PCS diagnosis codes, understand current professional coder workflows, reviews principal, secondary diagnoses and procedures for hospital and physician (professional) services for inpatient, outpatient, and infusion records based on knowledge of coding systems). Knowledge of hospital and professional billing, collection and reimbursement requirements and standard practice.</li>
<li>Must have working knowledge of drug NDC numbers and unit conversion</li>
<li>SME (Subject Matter Expert) for complex denials and payment variances including contracts, fee schedules, and edits. Educates and provides feedback to various areas on Pharmacy Revenue Cycle rejection metrics and key performance indicators.</li>
</ul>
Equal Opportunity Employer/Disabled/Veterans
According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or &ldquo;apps&rdquo; job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.</div>

Senior Claims Analyst, Pharmacy Revenue Cycle

OSF HealthCare

<div>Total Rewards:
<div>
&quot;Your life - our Mission&quot;</div><div>
OSF HealthCare is dedicated to provide Mission Partners with a comprehensive and market-competitive total rewards package that includes benefits, compensation, recognition and well-being offerings that focus on the whole person and engage with their current stage of life and career. Click here to learn more about benefits and the total rewards at OSF.</div><div></div><div> 
Expected pay for this position is $31.19 - $36.69/hour. Actual pay will be determined by experience, skills and internal equity. This is a Salaried position.</div>
Overview:
<div>
POSITION SUMMARY: The Revenue Cycle Trainer participates in the development of Ministry-wide training and delivers this training to newly hired and existing employees in a multi-faceted learning environment. The Trainer also participates in the development of strategic training initiatives to support continuous performance/quality improvement. This includes identifying training opportunities through competency assessments and performance audits and addressing those training opportunities through various learning activities. This role also creates and maintains educational materials in a variety of platforms and provides both technical and workflow support to employees.</div>
Qualifications:
<div>
REQUIRED QUALIFICATIONS:</div><div></div><div> 
Education: High school diploma or equivalent</div><div></div><div> 
Experience:</div><div>
2 years of experience in a healthcare revenue cycle role (Patient Access or Patient Accounts).</div><div>
Knowledge of accounting and general office procedures.</div><div></div><div> 
Licensure/Certifications:</div><div>
Must attain &ldquo;credentialed&rdquo; status within 12 weeks of hire and maintain this status as required by OSF in order to deliver training to end users.</div><div></div><div> 
PREFERRED QUALIFICATIONS:
</div><div>Education: Bachelor&rsquo;s degree in Accounting, Business Administration or a related area of study &bull;</div><div></div><div> 
Experience: 3-5 years of experience in a healthcare revenue cycle setting. 2-4 years of experience working as a classroom instructor and/or developing teaching plans and curriculum.</div><div></div><div> 
Other skills/knowledge:</div> 
<div></div><ul><li>
 Understanding of the revenue cycle including scheduling, registration, financial clearance, billing, and collections.</li><li>
 Knowledge of medical terminology.</li><li>
Analytical and troubleshooting skills and the ability to perform in a fast-paced, detail-oriented environment.</li><li>
Able to effectively use common technology tools, such as the Microsoft suite of products, in addition to various learning management platforms, such as Healthstream, Litmos, Canvas, uPerform, Panopto, etc.</li></ul><div></div><div> 
OSF HealthCare is an Equal Opportunity Employer.</div></div>

Trainer Revenue Cycle

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