Revenue Cycle Specialist

Job title Revenue Cycle Specialist Reports to

Practice Administrator Status :

Full-Time, Non-Exempt Schedule :

Monday - Friday 8:00 a.m. - 4:30 p.m. / Occasional Overtime is as needed based on business needs Summary of Responsibilities The Revenue Cycle Specialist is a staff position responsible for supporting the key financial operations of the practice through accurate payment posting, insurance claim follow-up, patient account resolution, surgery financial counseling, and reimbursement accuracy. This position plays a critical role in maintaining cash flow, supporting patient satisfaction, and ensuring financial operation within a busy ophthalmology practice. List of Responsibilities/Duties Submit, review, and monitor insurance claims for accuracy and timely payment. Work denied, rejected, and unpaid claims through resolution. Contact payers regarding claim status, underpayments, appeals, and reconsiderations. Maintain compliance with timely filing deadlines. Review aging reports and prioritize outstanding balances. Post insurance ERA/EOB payments, patient payments, contractual adjustments, transfers and refunds accurately. Reconcile daily deposits, batches, and payment totals. Investigate posting discrepancies and unresolved balances. Speak with patients regarding statements, balances, copays, deductibles, coinsurance, and payment options. Explain charges clearly, courteously, and professionally. Accept payments and establish approved payment plans per office policy. Help resolve billing concerns while maintaining a positive patient experience. Provide patient estimates for cataract surgery and other procedures based on insurance benefits. Explain expected out-of-pocket costs including deductibles, coinsurance, and elective/non-covered options. Collect deposits and balances according to practice policy. Ensure financial clearance is completed before scheduled surgery dates. Maintain HIPAA confidentiality standards. Document account activity thoroughly in the practice management system. Follow Medicare, Medicaid, and commercial payer billing requirements. Identify recurring issues and recommend workflow improvements. Duties and responsibilities may be added, deleted or changed at any time at the discretion of management, formally or informally, either verbally or in writing. Minimum Education and Background Requirements High school diploma or GED. Good verbal communication skills. One-year experience in cashiering or billing in a health care environment. Skill in computation, typing and filing. Ability to make simple mathematical computations. Basic coding knowledge. Minimum Demonstrated Skills Posts charges and payments accurately and promptly, including the proper use of modifiers. Maintains patient confidentiality at all times and communicates with the compliance officer regarding procedural changes and concerns. Assists patients willingly, professionally and accurately. Cooperates and communicates with all staff members and physicians. Attends required meetings. Participates in professional development efforts to stay current on insurance coverage changes and regulatory matters. Demonstrates a willingness to help as needed in all patient service roles. Complies with all other Patient policies and procedures including punctuality, attendance and dress codes. Word processing and computer experience required. Physical Demands Ability to handle and count cash accurately with minimal errors. Ability to sit for long periods of time, with occasional bending. Must be able to view and enter data into the computer for extended periods. Must be able to communicate via the telephone. The Americans with Disabilities Act requires that reasonable accommodations be made for qualified individuals to help perform the required duties and tasks of the position. Please let us know at the time you apply for a position if you will need any special accommodations. I have read and understand my job description.

Job Type:

Full-time Benefits:

401(k) Dental insurance Employee discount Health insurance Life insurance Paid time off Retirement plan Vision insurance

Work Location:

In person