Revenue Cycle Specialist II

Our Revenue Cycle Specialist directly contributes to our mission by timely and accurately billing the services we provide, collecting revenue, and working with families to make sure they feel supported throughout the billing and collections process.

This is a hybrid position - teammates will come in the office 2 days per month (assigned by manager) and will have a remote option on other days.

SPECIFIC RESPONSIBILITIES:

• Own a defined book of business within healthcare accounts receivable proactively identifying payer behavior patterns, validating correct reimbursement, and driving resolution to optimize collection performance.
• Denial response and accounts receivable follow up via Waystar and insurance portals
• Commercial and Medicaid, primary and secondary claims submission
• Work and manage claims from all aging buckets from initial billing through final resolution including identifying and correcting billing errors/rejections and denials
• Denial management investigations & appeals
  • Escalation at plan level to further understand processing and denials
  • Identify trends on a plan/insurance level and escalate to leadership timely
  • Input & Review billing data for accuracy, including data entry.
• Ensure that billing and collections adhere to all compliance policies and procedures.
• Follows up on claim resolution from initial billing through final
• Stay up to date on current payor processes and guidelines
• Other responsibilities as assigned by the billing manager and director

Skills and Competencies:

• 1-2+ years healthcare billing/collections experience required
• Central Reach and ABA experience preferred.
• Strong communication and presentation skills are important.
• Strong critical-thinking and deductive reasoning skills
• Confident communication skills for fielding calls on behalf of the agency and its representatives.
• Excellent written communication skills for professional emails and various reporting methods.
• Experience working with PA Medicaid payors a plus

Personality: A successful Team Member will be…

• Detail-oriented & highly organized
• Self-motivated
• Communicative & collaborative
• Committed to purposeful care
• Ambition to grow with the company