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Revenue Cycle Specialist

Reference ID:241327

Location

New Hyde Park, New York

Hourly

$23 - $30 / hr

Contract type

Part time

Work type

On-site

Description

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a detail-oriented and experienced Revenue Cycle Specialist to join their healthcare finance team. The ideal candidate will be responsible for managing and resolving out-of-network insurance claims and ensuring timely and accurate reimbursement. This role requires a strong understanding of medical billing, coding, and insurance procedures, along with excellent analytical and communication skills.

Key Responsibilities

Claims Management:
Review, submit, and follow up on out-of-network insurance claims to ensure timely payment.
Investigate and resolve claim denials and discrepancies by working with insurance companies, patients, and internal departments.
Appeal denied or underpaid claims by providing necessary documentation and evidence.

Account Reconciliation:

Reconcile payments and adjustments, ensuring accuracy in patient accounts and financial records.

Monitor accounts receivable aging reports and take proactive measures to collect outstanding balances.

Perform audits on patient accounts to identify and rectify errors.

Communication:

Communicate with insurance companies to verify coverage, obtain authorizations, and clarify payment policies.

Serve as a point of contact for patients regarding billing inquiries, providing clear and accurate information.

Collaborate with internal departments, including billing, coding, and patient services, to streamline processes and improve reimbursement rates.

Documentation and Reporting:

Maintain accurate and detailed records of all claims, payments, and communications with insurance companies.

Generate regular reports on account statuses, collection activities, and financial performance metrics.

Ensure compliance with federal, state, and payer-specific billing regulations and guidelines.

Qualifications

High school diploma or equivalent; associate's degree in healthcare administration, finance, or related field preferred.
Minimum of 2 years of experience in medical billing and accounts receivable, specifically with out-of-network claims.
Strong knowledge of medical terminology, billing codes (CPT, ICD-10), and insurance procedures.
Proficiency in using billing software and electronic health records (EHR) systems.
Excellent analytical, problem-solving, and organizational skills.
Strong verbal and written communication skills.
Ability to work independently and as part of a team in a fast-paced environment.

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

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