Revenue Cycle Specialist

Job Description

REQUIREMENTS

• Proficiency in medical coding including CPT coding, ICD-9, ICD-10, and DRG systems.
• Strong understanding of medical billing processes and healthcare reimbursement protocols.
• Experience working with EMR/EHR systems for data entry and claim management.
• Knowledge of medical terminology, medical records management, and healthcare compliance standards.
• Excellent communication skills for coordinating with clinical staff, insurance companies, and patients.
• Ability to analyze complex data related to medical collections and billing trends.
• Prior experience in a medical office environment or healthcare setting is highly preferred.

RESPONSIBILITIES

• Review and process medical claims using appropriate coding standards including CPT (Current Procedural Terminology), ICD-9, ICD-10, and DRG (Diagnosis-Related Group) classifications.
• Ensure accurate documentation of medical records and records management aligned with billing requirements.
• Collaborate with clinical staff to verify medical coding accuracy and resolve discrepancies in medical records.
• Manage accounts receivable by following up on unpaid or delayed claims through effective medical collection strategies.
• Utilize EMR (Electronic Medical Record) and EHR (Electronic Health Record) systems to input data, track claims status, and generate reports.
• Maintain comprehensive knowledge of medical terminology, billing procedures, and insurance guidelines to ensure compliance.
• Support the billing process by preparing detailed reports on claim status, denials, and rejections for review.

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