Revenue Cycle Specialist Resume Samples

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L Rosenbaum

Lila

Rosenbaum

1291 Lucius Forks

Dallas

+1 (555) 741 9053

1291 Lucius Forks

Dallas

Phone

p +1 (555) 741 9053

Experience Experience

San Francisco, CA

Revenue Cycle Specialist

San Francisco, CA

Gutkowski and Sons

San Francisco, CA

Revenue Cycle Specialist

Rounding to each area of service center to learn processes (Billing, AR follow up, Denials, Cash posting) to assist with determination of process improvement
Assists with maintaining practice management master files
Communicate and follow up with internal departments regarding the completion of provider files according to established criteria
Utilizes established project management tools and methodology to conduct revenue cycle assessments
Works toward meeting institutional goal of increasing revenue through improved charge capture processes
Assists in developing metrics to be used for ongoing monitoring
Assist with the development of policies and procedures that drive the day to day operations of the Program Revenue Cycle

Houston, TX

Healthcare Financial Applications \ Revenue Cycle Solution Specialist Flexible Locations

Houston, TX

Jakubowski, Wyman and Hagenes

Houston, TX

Healthcare Financial Applications \ Revenue Cycle Solution Specialist Flexible Locations

Help team of Financial/Business Solution experts in developing, marketing and enabling Dell Services Sales Executive team in driving solution in market
Assist with Solution launches alongside marketing team to ensure sales force readiness, accurate forecast and product transitions in the segments
A hunger for results and willingness to measure your own performance critically
Track record in developing executive level relationship
Functional sales responsibility for Financial/Business Applications within Dell Services Healthcare Provider space
Examine business opportunities, assesses potential markets, and develops projects for use in new marketing initiative
Value proposition development & strong business acumen

present

Chicago, IL

Senior Revenue Cycle Specialist

Chicago, IL

Effertz-Kuphal

present

Chicago, IL

Senior Revenue Cycle Specialist

present

Prepares and records financial transactions for assigned accounts to accumulate and record accurate and timely financial history. Ensures daily deposit reconciliation; maintains daily, monthly reporting for audit purposes
Works with manager to establish an implementation plan and can work independently or with support of Specialists to implement plan
Thinks critically through implementation of plans to identify gaps and make necessary adjustments
Identifies opportunities to improve revenue cycle processes and proposes solutions to capitalize on opportunities
Investigates and Resolves Claim Variances
Resolves client and audit issues to completion with attention to detail and the highest level of professionalism
Serves as a key point of contact for other departments on the audit and the client

Education Education

Bachelor’s Degree in Adherence

Webster University

Bachelor’s Degree in Adherence

Skills Skills

Ability to work well with others - strong teamwork skills, strong patient accounting systems knowledge and skills
Strong attention to detail and accuracy
Proficient knowledge in EPIC, Medicare & Texas Medicaid rules and regulations Managed care contractual agreements
Knowledge of basic accounting practices
Knowledge of basic accounting or finance practices
Knowledge of commercial insurance and managed care insurance terminology NT Windows Microsoft Office Applications (specifically MS Word and MS Excel)
Handles complex procedures within the revenue cycle including, but not limited to, coding, collections and postings
Ability to independently identify areas of concern regarding the various areas of the revenue cycle
Analyzes trends and issues and proposes appropriate action to resolve
Consistently exceeds established performance standard

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15 Revenue Cycle Specialist resume templates

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Healthcare Financial Applications \ Revenue Cycle Solution Specialist Flexible Locations Resume Examples & Samples

Assist the team in the strategy for Healthcare Financial/Business (Revenue Cycle) Application solutions
Functional sales responsibility for Financial/Business Applications within Dell Services Healthcare Provider space
Focus on pre-sales/solution support initiatives in the acquisition of new customers as well as enhancement of business within existing customers
Help team of Financial/Business Solution experts in developing, marketing and enabling Dell Services Sales Executive team in driving solution in market
Drive solution road maps, feature sets and solution improvements to meet customer needs
Assist in end to end Dell Strategy for specific solution leveraging all aspects of Dell (Services, Software and Product) including go-to-market, pre-sales, business development, and client facing c-suite sales
Thought leadership and brand awareness as demonstrated by white papers, social media participation, conference lectures, analyst meetings, reporters, and clients
Leverage a deep understanding of customers, the market, competition, and environment to create a product strategy and plan that will meet revenue growth
Assist with Solution launches alongside marketing team to ensure sales force readiness, accurate forecast and product transitions in the segments
Participate in competitive analysis to determine appropriate positioning and solution message
Provide Marketing and brand with up to date sales tools and training to help drive the business (solution road maps, etc.) and build relationships with Brand that facilitates the ability to influence and motivate
Periodically create and advocate business plans for new solution and service offerings
Examine business opportunities, assesses potential markets, and develops projects for use in new marketing initiative
8-10 years’ of Healthcare Provider work experience
5 or more years in the IT Services / Consulting Industry
5 or more years’ experience as solution architect or consultant driving Financial/Business (Revenue Cycle) solutions in Healthcare Provider market
Must have consultative selling skills and be able to demonstrate experience in working with CXOs across Healthcare Provider Industry
Value proposition development & strong business acumen
Track record in developing executive level relationship
Deep Solution Architect and/or Healthcare I.T. Services/Consulting Solution Sales experience
Proven ability to work and drive sales teams in selling solutions
A hunger for results and willingness to measure your own performance critically
Bachelor degree required (Masters Preferred)

Revenue Cycle Specialist Operational Staffing Pool Resume Examples & Samples

Excellent communication skills, oral and written
Ability to analyze data, perform multiple tasks and work independently
Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers and supervisors
Must be able to understand and comply with policies and procedures
Ability to work well with others - strong teamwork skills, strong patient accounting systems knowledge and skills
Must be flexible and able to function in a work environment where work and schedules may change to meet the needs of the customer

Revenue Cycle Specialist Resume Examples & Samples

Ability to analyze data, perform multiple tasks and work independently
Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers and supervisors
Must be able to understand and comply with policies and procedures
Ability to work well with others - strong teamwork skills, strong patient accounting systems knowledge and skills
Must be flexible and able to function in a work environment where work and schedules may change to meet the needs of the customer

Revenue Cycle Specialist Resume Examples & Samples

Analyzes the Unbilled report and the Denial Database to bill charges timely as well as identify trends to avoid future billing delays and denials
Researches, identifies and corrects billing errors
Prepares and maintains sufficient supporting documentation for all billing corrections
Corrects and re-submits re-bills to Third Party Payers
Serves as liaison between Patient Financial Services and other clinical departments
Minimum two years of experience in a health care environment
Minimum one year experience with ICD-9s, CPTs and/or HCPCS
Knowledge of Cleveland Clinic Billing systems preferred

Revenue Cycle Specialist Resume Examples & Samples

Billing/Charge Reconciliation Specialist activities to ensure accountability for all services performed and compliance with billing and internal standards is maintained
Identifies opportunities and efficiencies in business office functions and operations
Manages patient accounts receivable and conducts denial analysis
Monitors departmental accounts receivable to achieve appropriate reimbursement percentages and maintain financial stability within the department
Analyzes accounts receivable to identify inequities in payment
Collaborates with CCF contract management for resolution of payment issues
Conducts revenue-reporting analysis of costs associated with performing examinations and surgical/medical procedures and recommends fee modifications
Maintains departmental charge master files and performs ongoing reviews of professional and technical charges per compliance guidelines
Administers responsibilities associated with departmental expansion
Assists in practice startup, new service lines, and affiliate programs to ensure corporate compliance adherence to capture appropriate revenue
Completes finance accounting and maps revenue of billable services
Other duties include research analysis, IDE compliance, and billing follow up
Minimum four years extensive CPT and ICD 9 CM coding and medical billing and reimbursement experience
Understanding and applying third party and government payer regulations
Experience providing education and trend analysis related to revenue and reimbursement

Terrain Specialist, Revenue Cycle Resume Examples & Samples

Serving as partner to a territory of key accounts with the responsibility of cultivating executive relationships, growing Documentation CV, and driving cross-sell opportunities
Transforming current members into long term strategic relationships. The firm is committed to arming Terrain Specialists with tools and resources to enable them to drive a $10M+ revenue stream
Ability to scope all products and assets—Consulting, Technologies, and Research—that are viable for the Documentation terrain, including PDI, ROC and CDI
Accountability for the strong delivery of high quality work in specific accounts
Overseeing, educating, and motivating a team of business development and delivery experts around best-in-class approaches to sell and deliver to member executives in the Documentation terrain as well as oversee common sales and ROI goals and metrics
Serving as a Documentation terrain subject matter expert in the market with accountability for representing and communicating insights from the market as a member of a firm wide steering committee of Documentation terrain leaders
Jointly leading the long-term expansion of Documentation franchise by contributing to the build out of new tools and service lines, with the ability to test and take new offerings to market within his territory
Must possess a minimum of five years post-undergrad experience in at least two of the following
Experience in Sales, Account Management, and/or the equivalent
Must possess a minimum of five years of commercial experience – track record of successful sales/ownership over a personal revenue target
Proven ability to meet and exceed goals
Ability to conduct presentations and facilitate group discussions
Willingness to travel domestically at least 50%
Engaging and memorable presentation style; demonstrated ability to build rapport and credibility quickly with an executive-level audience
Proven track record of success in achieving revenue quotas and sales targets
Demonstrated ability to use active listening to diagnose a problem and map a solution in the moment
Demonstrated creativity and initiative when it comes to problem solving and/or project ownership
Proven experience managing multiple, competing priorities, strong prioritization and organizational skills
Excellent writing, critical thinking and negotiation skills
Consultative-based sales experience
Experience identifying market trends, presenting in a leadership forum and leveraging to inform overall go-to-market strate

Revenue Cycle Cash Posting Specialist Resume Examples & Samples

Oversee cash application and work with the billing team to ensure correct cash linkage occurs
Efficient and accurate application of customer payments by the end of each business day
Assist with handling customer account reconciliations (review unapplied cash and credit memos daily to determine which invoices they should be applied to)
Work with the Billing team to update the Unallocated Customer Receipts and Deferred Income and Prebill reports
Contact customers via telephone or email when necessary to determine proper payment application
Working knowledge of computers and demonstrated proficiency in using email systems, internet and MS office software applications with emphasis in excel
Knowledge of Microsoft Excel including pivot tables, VLOOKUP, SUMIF functions
Strong interpersonal skills and ability to work collaboratively across an organization

Revenue Cycle Systems Optimization Specialist Resume Examples & Samples

Provide end-user client support to business partners (i.e., KP HealthConnect, ePremis, Patient Business Services, KPIT, General Accounting, Claims Department, etc.) during revenue cycle impacted system implementation and/or new releases which includes system testing, issue identification and resolution, documentation, status reporting and risk mitigation. Responsible for assisting with the stabilization of new informational systems that affect the revenue cycle (i.e. Epic Resolute Professional Billing and Hospital Billing, Diamond, PIMS, ePremis, etc.). Serve as the revenue cycle systems liaison for KP HealthConnect, Epic, ePremis, and other business partners as it pertains to the revenue cycle. Work collaboratively with business partners to resolve complex revenue cycle system issues
Direct configuration activities in Epic System to resolve problems escalated to the RC Systems Optimization Department. Set up and test configuration to resolve complex modifications and requests from business partners throughout NW's Revenue Cycle Build. Build, maintain and update application WQ's to ensure data integrity
Contribute to the development and maintenance of system education materials. Create written procedural documentation for system controls to assist in training and compliance. Create and maintain tools to effectively perform system audit functions. Providing education and/or training as needed when patterns of errors are identified, changes in systems occur, or when proactive measures are needed
Maintain current knowledge and system skills. Perform other duties as required
Minimum three (3) years of insurance billing experience in a medical, hospital, and/or insurance office setting
Minimum three (3) years of experience working with and/or managing computer applications for end-users in a medical and/or financial area
Minimum three (3) years of experience at Kaiser Permanente
Minimum two (2) years of experience using Epic's Resolute Professional and/or Hospital Billing modules
Experience with decision support systems, data warehouse and/or management reporting
Experience with Microsoft Office, including Access, Excel, Word, and PowerPoint
Knowledge of large-scale clinician practice and hospital billing computer systems
Knowledge of health plan membership, pharmacy and claims database systems
Knowledge of research and analyses/design
Knowledge of systems analysis
Knowledge of HMO products and audit functions

Senior Revenue Cycle Specialist Resume Examples & Samples

Identifies opportunities to improve revenue cycle processes and proposes solutions to capitalize on opportunities
Works with manager to establish an implementation plan and can work independently or with support of Specialists to implement plan
Thinks critically through implementation of plans to identify gaps and make necessary adjustments
Investigates and Resolves Claim Variances
Serves as a key point of contact for other departments on the audit and the client
Resolves client and audit issues to completion with attention to detail and the highest level of professionalism
Conducts research and resolution on outstanding claims
Payment Postings and Reconciliations. Posts payments to collection accounts, reconciles with posted bank transactions, works with AP department to have refund issued when needed, reconciles monthly bank statements with cash posting database. Posts adjustment transactions to collection system as well as client’s system. Systems Capability
Access and understand necessary information from the various online systems, understanding the systems process in determining how a claim has been paid in order to accurately apply payments and adjustments and assists in determining the adjudication of funds. Has a detailed understanding of client systems and processes. Can serve as a subject matter expert on client processes. Account Reconciliation
Prepares and records financial transactions for assigned accounts to accumulate and record accurate and timely financial history. Ensures daily deposit reconciliation; maintains daily, monthly reporting for audit purposes

Revenue Cycle Specialist Resume Examples & Samples

Payment Postings and Reconciliations. Post payments to collection accounts, reconciles with posted bank transactions, works with AP department to have refund issued when needed, reconciles monthly bank statements with cash posting database. Posts adjustment transactions to collection system as well as client’s system
Cash Application. Performs cash application functions and processes relevant to the Corporate and client requirements in a manner that meets or exceeds key performance criteria
Systems Capability. Access and understand necessary information of the various online systems, understanding the systems process in determining how a claim has been paid in order to accurately apply payments and adjustments and assists in determining the adjudication of a refund
Account Reconciliation. Prepares and records financial transactions for assigned accounts to accumulate and record accurate and timely financial history. Ensures daily deposit reconciliation; maintains daily, monthly reporting for audit purposes. Reconciles daily deposit totals, review and correct discrepancies. Responsible for cash balancing and reconciliation of bank deposits and communication between internal and external customers
Research and Resolution. Researches and accurately distributes payments with no apparent invoice number, or date-of-service. Researches and determines the correct claim for the payment if there is a valid patient/date of services and accurately applying payment to correct claim
Ensures Compliance. Maintains thorough and detailed knowledge of compliance and recovery laws regarding processing and recoupment to ensure compliance with state laws regarding all cash processes as evident through the collection cycle
Meets or Exceeds Standards for Productivity. Maintains productivity goals and standards set by the department. Insures all department rules and processes are followed. Alerts manager of system issues or other issues impacting productivity
Meets or Exceeds Standards for Quality. Achieves the expected level of quality set by the department. Verifies completeness and accuracy of work. Alerts manager of issues or concerns impacting quality of work

Revenue Cycle Specialist Resume Examples & Samples

Serve as an essential communication link for the Hospitalist Services and Billing Company, including collection and coordination of information necessary for provider billing
Collect, log and batch insurance, demographic, clinical and encounter data and forward to the billing company
Responsible for maintenance of registration and charge tracking log
Identify and resolve missing charges
Work with physicians to obtain missing encounter forms
Collaborate with client representatives to obtain information and resolve issues
Maintain an orderly computer filing system and records for the Program
Perform general duties including copying, faxing, scanning
Communicate with billing company and gather additional information that they requested
Provide excellent customer service to all staff, physicians, patients and/or outside vendors for administrative related inquiries and/or needs
Maintain strict confidentiality of documents and comply with HIPAA regulations stipulated by the facility and government
Perform other administrative duties as requested by the Hospitalist staff
Perform clinic duties as needed, such as scheduling patients, mailing test results, and preparing paperwork

Revenue Cycle Specialist Resume Examples & Samples

· High School Diploma or equivalent; AA degree and/or Bachelors in Health Information Management or Health Administration
· Special skills which are required include a thorough knowledge of medical terminology, anatomy and physiology, disease processes, working knowledge of coding systems (ICD9, ICD10, HCPCS, CPT, etc.), knowledge of management care/third party reimbursement (DRG, per diem, etc.), office computer applications, and effective oral and written communication
· RHIT/ RHIA AHMIA certification or HIM Certification Required

Revenue Cycle Specialist Resume Examples & Samples

Handles complex procedures within the revenue cycle including, but not limited to, coding, collections and postings
Ability to independently identify areas of concern regarding the various areas of the revenue cycle
Analyzes trends and issues and proposes appropriate action to resolve
Consistently exceeds established performance standard
Works independently on special projects and follows through to completion
Ability to step in as acting supervisor as needed
Minimum of three years of directly related experience, preferably with a Baylor College of Medicine department
Knowledge of commercial insurance and managed care insurance terminology NT Windows Microsoft Office Applications (specifically MS Word and MS Excel)
Proficient knowledge in EPIC system, Medicare & Texas Medicaid rules and regulations, managed care contractual agreements, third party payers protocols and Baylor College of Medicine confidentiality standards CPT/ICD coding

Revenue Cycle Specialist Resume Examples & Samples

Bachelors Degree in Finance, Accounting or Business preferred
Knowledge of basic accounting or finance practices
Computer proficiency in Microsoft Office applications, system databases are required
Knowledge of basic accounting practices
Excellent organizational ability required to handle multiple priorities
Requires working knowledge of and applicable industry based standards
Ability to work well in an individual and team environment

Revenue Cycle Specialist Resume Examples & Samples

Assist with the development of policies and procedures that drive the day to day operations of the Program Revenue Cycle
Monitor and audit all physician/provider files to ensure all documents are complete and appropriate signatures are obtained
Communicate and follow up with internal departments regarding the completion of provider files according to established criteria
Follow up with providers to obtain appropriate signatures on billing related documents
Monitor outstanding billing tasks weekly at the program level working closely with third party billing companies and internal staff
Enter file information into computer systems and develop tracking mechanisms in order to monitor contents of each file
Serves as primary contact to physician office staff, internal and external billing department to evaluate the issue and determine the necessary course of action
Performs analysis and special projects for billing, compliance and operations initiatives as needed
Assists with monitoring and auditing of external and internal billing to monitor productivity and project completion deadlines
Analyzes billing reports to identify problematic areas that require additional focus and initiates procedural or system changes as required improving the revenue cycle
Researches literature and Internet to find answers and provide recommendations to specific questions concerning billing, compliance and reimbursement
Assists with maintaining practice management master files
Reviews refund requests for accuracy and payor specific requirements
Assists with maintaining and updating policy and procedure manuals
Maintains compliance with HIPAA, Medicare, Medicaid and third party payors
Follows Delphi and department policies and procedures with special attention to attendance and punctuality, confidentiality, dress code and safety
Provides coverage for the Front Desk/Receptionist on a rotating basis
Performs other duties as required and assigned by the Billing Director. These may, on occasion, be unrelated to the position described here

Revenue Cycle Specialist Resume Examples & Samples

Assists clinical departments (holds inservices, etc.) in their understanding of how their clinical operations, revenue cycle processes, and compliance are inter-related
Assists external customers as requested with questions regarding hospital charging, coding, or documentation
Participates in institutional committees as relevant
Assists Business Office with technical expertise for coding questions related to denied claims or complex charge questions
Work closely with the CDM Process Manager and other Revenue Cycle Specialists on on-going charging and billing activity
Bachelor’s degree in clinical program required
Minimum five (5) years of varied clinical experience as a RN, APN, or other clinical specialist required
Working knowledge of coding rules required or willingness to obtain within 3 months of hire
Licensed health care practitioner (PA/NJ licensing preferred)
Coding certification
Pediatric experience
Experience with Clinical expertise in Pediatricsbilling and documentation systems

Revenue Cycle Specialist Resume Examples & Samples

Ability to step in as Acting Supervisor as needed
Required knowledge of: Commercial insurance and managed care insurance terminology NT Windows Microsoft Office Applications (specifically MS Word and MS Excel)
Proficient knowledge in EPIC, Medicare & Texas Medicaid rules and regulations Managed care contractual agreements
Third party payers protocols Baylor College of Medicine confidentiality standards CPT/ICD coding Baylor College of Medicine policy and procedures Ability to work in a fast-paced environment and deal with stressful situations with resourcefulness and initiative
Ability to accept training, instruction and change with a positive attitude is essential
Courtesy, technical skills, professionalism, interpersonal skills and maturity are required to maintain and promote the prestige and image of Baylor College of Medicine
Ability to earn the confidence and trust of peers as a chosen leader

Revenue Cycle Specialist Resume Examples & Samples

High school or equivalent, good verbal communication and written comprehension skills, and knowledge of basic computer skills
College level courses in finance, business or health insurance preferred
Ability to read and analyze EOBs required
Ability to validate appropriately invoice numbers/denial codes using the Health Logic payment process application
Each processor processes all payments/denials files received from HL, same day process
Ability to map denial codes to HL application
Ability to index images with Onbase/Epic application
Demonstrate ability to handle multiple tasks in a fast paced and high volume environment with conflicting demands with time and attention
Research of incoming payment request from all cash collection areas throughout the Health System/offsite
Resolve in a timely and accurate manner the daily transfers/refunds associated with misposted/misdirected or unallocated payments
Ability to successfully complete PRMPT I within 6 month of hire date

Revenue Cycle Specialist Resume Examples & Samples

A minimum of two (2) years billing experience. Basic knowledge of UB04 required. Ability to understand different bill types and their purpose and/or billing process
Ability Its successfully complete PRMPT I within 6 months of hire date
Ability to perform relevant mathematical calculations. Ability to understand payer contracts
Must be able to operate a computer and demonstrate Windows navigation skills. Experience with MS office, Web/Vs, Emdeon and CS-Link preferred
Ability to interact with, understand and update applications used to manage patient accounts and to access alternative information sources when necessary
Detail and problem-solving aptitude. Typing 40 to 45 wpm (45 to 50 wpm preferred)
Experience demonstrating the ability to handle multiple tasks frequently and with short timelines, to prioritize and organize work, and to complete assignments in a timely, accurate manner
Professional and courteous demeanor. Ability to work and communicate well with others. Demonstrates customer service skills

Revenue Cycle Specialist Resume Examples & Samples

Acts as a liaison between the Central Billing Office (CBO) and the practices on front-end billing operations, reimbursement trends and basic training needs. Meets with each practice (leadership) at least monthly to review month-end reports. Recommends enhancements and implements action plans in collaboration with practice management to improve cash collections, reduce charge lag, improve registration accuracy and decrease front-end denials
Monitors daily/weekly/monthly performance of front-end billing functions/tasks to ensure compliance with revenue related goals. Escalates any negative trends to the appropriate staff. Discusses trends with local leadership to help identify root causes and collaboratively develops action plans to improve results
Proactively identifies, troubleshoots and resolves front-end revenue relates issues or barriers to maximizing revenue. Listens to feedback and recommendations from the practices and champions change to existing workflows and system processes on behalf of all IPM Markets. Lobbies and advocates on behalf of the practices to improve communication, team work and overall results. Actively participates in CBO meetings to share market-based initiatives, best practices and barriers so that issues are communicated and resolved in a holistic approach versus silos
Responsible for facilitating/onboarding specific revenue cycle processes in new IPM practices as well as IPM practice leadership. Participates in pre-acquisition meetings to ensure revenue cycle processes are addressed. Provides any needed support during the acclimation period. Actively participates in any post go-live meetings
Works collaboratively with the EMR Specialists to ensure consistent and coherent processes that involve charge capture within the EMR and the impact to charges transferring to the practice management system. Assists (along with the CBO) with resolving suspended charges when caused by lsquofront-end' or EMR related issues

Revenue Cycle Management Specialist Resume Examples & Samples

Actively participates in product sales including pre-sale needs assessments/ discoveries, onsite product demonstrations, and follow-up activities as needed to progress the sales cycle
Educates assigned sales team on new product functionality, product presentation techniques, and industry/market trends
Collaborates with Product Marketing, Product Management, and Sales Support team to learn, apply, and teach
Industry/market events and product positioning
Represents Greenway Health in regional/national tradeshows through exhibit demonstrations and/or speaking opportunities
Reports activity levels for demonstrations and properly manages demonstration requests and follow-up activities
Pull GRS reports and present GRS financials

Revenue Cycle Integrity Specialist Resume Examples & Samples

Minimum of 5 years experience in Revenue Charge Capture
Knowledge of ICD-9, CPT-4 and HCPCS coding, as well as CMS-1500 and UB-04 forms required
Knowledge of patient registration, charge capture coding requirements, billing and adjudication of account
Minimum of 5 years experience in all facets of the Revenue Cycle
Experience using healthcare web-based applications

Revenue Cycle Research Specialist Resume Examples & Samples

Effective verbal and written communication skills and the ability to present information clearly and professionally to varying levels of individuals throughout required job processes
Must be proficient with Windows-style applications, keyboard, and various software packages specific to role
Working knowledge of medical terminology utilized in medical billing including Current Procedural Terminology (CPT) and International Classification of Diseases Codes (ICD-10 and ICD-9) code
Working knowledge of record keeping using an automated system and/ or health care billing including Medicaid, Medicare, or other third party payers
Working knowledge of public and private sources of assistance and methods of qualifying for funding
Working knowledge of collection laws, regulations and techniques; current office practices and procedures

Revenue Cycle Specialist A / R Follow Up Resume Examples & Samples

Understands and interprets insurance Explanations of Benefits (EOBs), knowing when and how to ensure that maximum payment has been received
Researches and resolves rejected, incorrectly paid, and denied claims within an established time frame
Researches and resolves unpaid accounts receivable and makes any corrections in practice management system necessary to ensure maximum reimbursement for all Stamford Health Medical Group (SHMG) services
Resubmits claim forms as appropriate
Professionally responds to all billing-related inquiries from patients, staff, and payors in a timely manner
Utilizes available resources to identify reasons for payment discrepancies
Keeps management informed of changes in billing requirements and rejection or denial codes as they pertain to claim processing and coding
Accurately documents patient accounts of all actions taken
Establishes and maintains a professional relationship with all SHMG staff in order to resolve problems and increase knowledge of account management
Educates clinic management and staff regarding changes to insurance and regulatory requirements
Actively participates in practice management meetings
Completes additional projects and duties as assigned. SHMG
Associate in arts degree preferred
3 years of experience working in a multispecialty group practice, healthcare system with an ambulatory focus, or academic medical center
3 years of experience in working with a medical office/hospital accounts receivable system
Extensive knowledge of insurance payor reimbursement, collection practices, and accounts receivable follow-up
Basic computer skills, including Microsoft Windows programs
Good keyboard skills with high accuracy rate
Ability to communicate effectively in written and spoken English
Demonstrates overall knowledge of claims processing for various insurances both private and governed
Demonstrates effective communication and interpersonal skills with a diverse population
Demonstrates the ability to carry out assignments independently, work from procedures, and exercise good judgment
Demonstrates the ability to maintain the confidentiality of all records
Demonstrates knowledge of Medicare, Medicaid, and third-party coding requirements

Revenue Cycle Specialist Resume Examples & Samples

Compile Spread sheet by client for Invoicing of revenue to leadership – requires balancing of revenue and discussing results with client
Collaborate with leadership to get invoicing approved to submit to finance to bill client’s for payment
Data entry and review for accuracy
Track internally invoicing by Service Center to paid invoices to ensure nthrive revenue is being recognized
Learn cash posting process for services organization to include Bank Account information from client
Reconcile financial cash that is posted into the clients systems (work with client to ensure accuracy)
Verify Cash reported to finance for invoicing is balanced and correct
Ability to learn systems to run/analyze reports to assist leadership with AR opportunities
Rounding to each area of service center to learn processes (Billing, AR follow up, Denials, Cash posting) to assist with determination of process improvement
Document processes and workflow to standard best practice
Performing database maintenance
Printing, scanning and copying documents ie: Medical records, IZ’s, invoices, letters
Reconciliation of pending and closed status reports
Serves as a back up to the receptionist at the corporate or regional hub locations. This can include answering phones, meeting and greeting visitors, and assisting with the daily mail
Minimum two years in an office setting
Intermediate working experience with word, excel and outlook
Excellent verbal and written communication skills are essential for communication with clients
Strong organizational and coordination abilities are required
Banking knowledge preferred