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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in healthcare revenue cycle management, including insurance claims processing and reimbursement. Proficient in maintaining compliance with Medicaid and Medicare billing regulations while ensuring accurate documentation and effective communication.
Highest-signal resume keywords
Healthcare Revenue Cycle ManagementInsurance Claims Processing1500 Claim Forms ExperienceMedicaid and Medicare Billing RegulationsBilling Editor Systems
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Accounts Receivable ManagementBilling Guidelines MaintenanceICD Coding Language KnowledgeAging Reports AssistanceClaim Documentation ReviewIssue Identification and CommunicationProcess Execution EfficiencyConfidentiality Under HIPAA GuidelinesReimbursement KnowledgeFinancial Services Functions
Soft Skills
Time ManagementSelf-DirectionCustomer Service SkillsCommunication SkillsMulti-Tasking Ability
Tools & Technologies
Google SpreadsheetsMicrosoft Office ProductsExcel SpreadsheetsBilling Editor Systems
Industry Keywords
Revenue Cycle ProcessPayer Issues ReportingDenial Trends AnalysisThird-Party Payer CompliancePHI Requirements
About the role
Key responsibilities & impact- Follow up on billed claims and resolve accounts in a timely manner
- Oversee accounts receivable and maintain detailed, accurate account documentation
- Follow up on open claims with complete supporting documentation
- Maintain and update billing guidelines, fee schedules, and contract rates
- Review, document, and resolve incoming correspondence and payer calls
- Assist with aging reports and payments as needed
- Report payer issues and denial trends to the Lead/Supervisor
- Appeal or rebill underpaid claims as needed
- Review billing claim forms for accurate and aligned fields
- Identify and return incomplete claim information or supporting documentation
- Initiate contact and respond to inquiries from external sources
- Answer questions and assist Accounts Receivable with billing issues
- Meet departmental productivity and quality standards after training
- Work Monday–Friday, with a flexible start time between 7:00 a.m. and 8:30 a.m. after training
Requirements
What you’ll need- Experience in healthcare revenue cycle, insurance claims processing, reimbursement, or related financial services functions
- Demonstrated self-direction and exemplary time management skills
- Ability to manage multiple tasks simultaneously
- Ability to execute processes efficiently while maintaining high quality
- Ability to identify and communicate issues
- Computer literacy, including Google and Excel spreadsheets and Microsoft Office products
- Enhanced communication and customer service skills
- Experience and working knowledge of 1500 claim forms
- Experience with billing editor systems
- Understanding of the entire revenue cycle process
- Knowledge of Revenue and ICD coding language
- 1–2 years of back-end revenue cycle experience in a facility and hospital setting
- Knowledge of Medicaid and Medicare billing regulations
- Ability to maintain confidentiality under HIPPA guidelines
- Ability to comply with government, third-party payer, regulatory, billing, collections, and PHI requirements
Benefits
Comp & perks- Generous benefits package covering programs supporting physical, mental, and spiritual well-being
- Wellness programs supporting healthy, happy, secure, connected, and engaged living
- Remote/hybrid work expectations include use of company equipment
