Revenue Cycle Specialist

• Manage internal billing and collection activities for the practice
• Oversee the full billing lifecycle, including claim creation, submission, investigation, corrections, adjustments, payment posting, and accounts receivable workflows
• Review claims for accuracy and identify billing issues before submission
• Investigate and resolve claim rejections, denials, and underpayments; submit corrected claims and appeals
• Review accounts receivable aging reports to ensure timely reimbursement
• Serve as liaison between the practice and external billing vendors
• Manage patient balances and collection activities
• Contact patients about outstanding balances and establish payment arrangements
• Process patient payments and maintain accurate account balances
• Reconcile payment discrepancies and research billing concerns
• Maintain accurate financial documentation and patient account records
• Serve as primary contact for the billing phone line
• Answer patient questions about deductibles, copayments, coinsurance, eligibility, benefits, financial responsibility, balances, payment plans, statements, and charges
• Provide billing statements, itemized receipts, and payment histories
• Explain billing information clearly, professionally, and compassionately
• Resolve patient billing concerns and escalate complex issues
• Monitor and report revenue cycle metrics, including days in accounts receivable, AR aging, clean claim rate, claim creation and submission lag, payment posting timeliness, and patient collection performance
• Maintain compliance with HIPAA, payer guidelines, and applicable federal and state regulations
• Ensure billing documentation supports medical necessity and payer requirements
• Collaborate with administrative staff and practice leadership to resolve billing concerns and improve processes

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