CAN Community Health

Revenue Cycle Specialist

• Support the financial integrity of the organization through payment reconciliation, accounts receivable follow-up, refund and credit processing, payment posting reconciliation, reporting, auditing, and billing support
• Ensure accurate revenue cycle operations, timely issue resolution, and effective collaboration with internal teams, vendors, patients, and external partners
• Promote and practice the organization’s mission and values and follow its policies and procedures
• Maintain confidentiality regarding patient/client information in accordance with HIPAA, professional, and departmental standards
• Assist with RCM processes and process improvements
• Proactively maintain knowledge of billing systems and processes, including EMR workflows and Clearinghouse vendors
• Process credits and refunds accurately and efficiently and maintain records of credit/refund transactions
• Participate in monitoring claim status volumes and assist with auditing activities
• Follow up on denied, unpaid, or rejected claims and resolve billing issues
• Assist with month-end reporting and reconciliation of payments and disbursements
• Communicate with patients, healthcare providers, insurance companies, and third-party administrators regarding billing processes, inquiries, and discrepancies
• Respond to internal and external stakeholder inquiries regarding billing issues
• Coordinate and fulfill revenue cycle provision requests from R1 as needed

Revenue Cycle Management, RCM Specialist