Revenue Cycle Specialist

Job Description

Job Description

Revenue Cycle Specialist

This Jobot Job is hosted by : Cody Timm

Are you a fit? Easy Apply now by clicking the "Apply Now" buttonand sending us your resume.

Salary : $26 - $29 per hour

A bit about us :

We are a fast-growing Infusion Suites company providing therapeutic, intravenous infusions to outpatients. Infusions include biological medications, intravenous immunoglobulin, blood products, and antibiotic therapy.

Other services include medication injections and IV Hydration. We’ve grown from 4 infusion suites to 9 in the past year and anticipate growing at a similar pace in 2025.

Our 9 locations are in located throughout LA, OC, Riverside, and San Diego. We just opened our first Infusion Suite in Arizona and are continuing to expand throughout the Southwest area of the United States!

Why join us?

• Competitive pay
• 401k matching
• 100% employer-paid medical insurance
• Life and Disability insurance
• PTO and Holiday Schedule
• Growth opportunities

Job Details

The Revenue Cycle Specialist is responsible for performing the day-to-day operations of the revenue cycle processes specific to infusion services and supporting the staff performing billing, cash posting and collections.

This role involves overseeing the billing, coding, and collections processes ensuring the accurate and timely processing of claims, reducing denials, and optimizing collections.

This role also performs Intake support functions as needed.

1. Functions as lead for team performing healthcare billing, cash posting, and collections.

2. The lead's job functions include performing all functions and supporting all staff whose responsibility is to ensure the timely and accurate data entry, billing, cash posting, and collections of accounts receivable within assigned specialty.

3. Lead supports management in achieving all team goals related to turn around time, clean claim rate, cash collections, aging, and denial management

4. Oversee the infusion billing, coding, and collections processes, ensuring accuracy and compliance with industry standards and payer requirements.

5. Incumbents are expected to research, analyze and resolve complex cases and problem accounts with minimal assistance.

6. Monitor workflows and identify areas for process improvements, implementing changes as needed to enhance operational efficiency.

7. Assist team members in complex billing and coding issues, providing guidance and resolution.

8. Review, track, and analyze claims, denials, and underpayments specific to infusion services.

9. Work with the team to address denials and follow up with payers to ensure timely resolutions.

10. Oversee insurance verification processes and ensure prior authorizations are obtained for infusion services.

11. Communicate with insurance payers to resolve any coverage discrepancies and ensure smooth claims processing.

12. Communicate with patients to address billing inquiries, provide explanations of benefits, and set up payment plans when necessary.

13. Serve as a point of contact for payer representatives to address claim issues and ensure optimal reimbursement.

14. Intake duties :

• Build Patient profiles and upload medical records into the system.
• Communicate with Medical Doctor Offices to request complete patient records.
• Communicate with patients to discuss their referrals.
• Assist with scheduling of patients if needed.

15. Work closely with clinical staff to ensure accurate charge capture and proper documentation for infusion services.

16. Collaborate with other departments to align revenue cycle practices with overall organizational goals.

17. Participate in monitoring of key performance indicators (KPIs) that provide insight to the daily operations, assure effectiveness, and guide continuous improvement.

Qualifications :

2+ years of Revenue Cycle experience : including appropriate healthcare transactions such as billing, insurance follow up, both government and non-government, hospital and physician, denials management, underpayments / zero payments, and other revenue cycle functions.

1+ years Medical Billing experience.

Interested in hearing more? Easy Apply now by clicking the "Apply Now" button.