Revenue Cycle Specialist I

The Revenue Cycle Specialist is responsible for analysis and monitoring of claims audit data across multiple platforms. Performs various follow-up activities to ensure the accuracy and appropriateness of reimbursement made to healthcare providers.

Requirements

• Analyze and adjust/reprice claims to ensure accurate reimbursement rates in accordance with contractual agreements and payer guidelines
• Establishing and maintaining accurate pricing structures and rules to ensure competitive and profitable pricing strategies across various claims
• Identify payment variances and work internally and externally to resolve such issues
• Perform contract and reimbursement variance analysis
• Assist department and leadership in obtaining complex information from various financial, clinical and operational systems and data sources
• Learns or remains current on billing protocols and regulations, federal and state regulations, and internal procedures that affect processing
• Identify trending opportunities related to policies and procedures to ensure efficiency and accuracy in bill processing
• Produce daily, monthly and annual evaluative and statistical reports, analyzing drivers of variances from period to period to ensure the integrity and accuracy of revenue cycle data

Benefits

• Medical (HDHP) w/Pharmacy
• Dental
• Vision
• Long Term Disability
• Health Savings Account
• Flexible Spending Account Options
• Life Insurance
• Accident Insurance
• Critical Illness Insurance
• Pre-paid Legal Insurance
• Parking and Transit FSA accounts
• 401K
• ROTH 401K
• Paid Time Off