Revenue Cycle Specialist

Job Summary:

The Revenue Cycle Specialist is responsible for all facets of the revenue cycle which includes but not limited to billing, handling and posting incoming payments, calculating patient intake costs, tracking accounts receivable, and credentialing with all insurance carriers. May also be assigned to special projects and must demonstrate a sincere dedication and loyalty to the mission, vision and core values of BRMC.

Essential Job Duties and Functions:

Review and resolution of patient information collected, such as demographics, insurance coverage, and updating the EHR as needed. Review and resolution of insurance information, such as confirming insurance and validating insurances benefits and limits. Communicate with patients to ensure understanding of insurance coverage for upcoming appointments. Review billing discrepancies on claims for accuracy and specification. Work with providers to ensure proper and prompt billing and clean encounters. Prepare and/or review monthly billing statements. Process payments from insurance companies and patients. Research and correct insurance denials. Review and resolution of medical A/R - including contacting patients for payments, negotiating payment arrangements, sending accounts to collections. Maintain knowledge of health plans and BRMC's requirements for credentialing providers. Responsible for coordinating, reviewing, and completing insurance credentialing applications with various insurance companies. Provide reports of provider's credentialing process status to staff within BRMC. Stay current on all billing regulations. Follow the No Surprise Act requirements. Other duties as assigned.