Experience Inc. Jobs

Job Summary:

The Revenue Cycle Specialist is responsible for managing specific components of the revenue cycle, including billing, claims processing, payment posting, and collections. This role ensures that revenue is captured accurately and efficiently, contributing to the financial health of the organization. The Revenue Cycle Specialist also interacts with patients, insurance companies, and other stakeholders to resolve billing issues and ensure timely payment.

Key Responsibilities:

• Billing and Claims Processing:
  • Prepare and submit accurate and timely claims to insurance companies, Medicare, Medicaid, and other third-party payers.
  • Review patient accounts for accuracy, ensuring that all necessary documentation is included.
  • Follow up on unpaid or denied claims, working to resolve issues and resubmit claims as needed.
• Payment Posting:
  • Accurately post payments from insurance companies, patients, and other sources to the appropriate accounts.
  • Reconcile posted payments with account balances and resolve discrepancies.
• Patient Account Management:
  • Respond to patient inquiries regarding billing statements and account balances.
  • Assist patients with setting up payment plans or resolving billing disputes.
  • Ensure patient billing is transparent, clear, and compliant with regulatory requirements.
• Collections:
  • Manage accounts receivable, following up on overdue accounts to ensure timely collections.
  • Work with patients to collect outstanding balances while maintaining positive relationships.
  • Prepare accounts for collections or write-offs, following established policies and procedures.
• Compliance and Documentation:
  • Ensure compliance with federal, state, and local regulations, including HIPAA and other healthcare laws.
  • Maintain accurate and up-to-date records of billing activities, claims, payments, and communications.
  • Assist with audits and reporting as needed.
• Communication and Collaboration:
  • Communicate effectively with insurance companies, patients, providers, and other departments within the organization.
  • Collaborate with other team members to resolve issues and improve processes.
  • Participate in regular team meetings to review performance, discuss challenges, and share updates.

Qualifications:

Education:

• High school diploma or equivalent required.

Experience:

• Minimum of 2-3 years of experience in a revenue cycle, billing, or collections role within a healthcare setting.
• Experience with insurance claims processing, payment posting, and accounts receivable management.

Skills:

Strong understanding of healthcare billing and coding practices.

Proficiency in using revenue cycle management software and electronic health records (EHR) systems.

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