Senior Revenue Cycle Specialist

Senior Revenue Cycle Specialists are responsible for problem resolution and payment collection of complex billing transactions. Utilizes expert problem-solving skills to resolve complex billing issues, unpaid claims, and customer complaints, taking all steps and coordinating corrective action of a multi-functional nature to ensure full resolution of prompt payment. Key Job Elements • Handles correspondence related to insurance or patient account, contacting insurance carriers as needed to get maximum payment on accounts and identify issues and corrective action to be taken. • Identifies trends taking action to help prevent reimbursement issues and delinquent accounts. Utilize the identified trends and pattern recognition to identify defects and eliminate them at the source. Collaborate with leadership and other key stakeholders to make solution recommendations. • Utilizes expert problem-solving skills to resolve complex billing issues, unpaid claims, and customer complaints, taking all steps and coordinating corrective action of a multi-functional nature to ensure full resolution of prompt payment. • Examines all documents to ensure bills are compliant. Determines appropriate steps and communicates critical information to insurance companies, patients, and leadership both verbally and in writing, to ensure concerns are resolved in a timely manner and accounts are settled in full. • Communicates with carriers, patients, and management of all levels as needed to get maximum payment/resolution on accounts and identifies/resolves issues or changes to achieve profitability. • Acquires knowledge of payor fee schedules and denials. • Demonstrates in-depth understanding of Medicare, Medicaid and private payors, policies and guidelines. • Researches and resolves denials making appropriate decisions on accounts to maximize reimbursement. • Works aging reports of unpaid claims to resolve claims. • Works complex projects and assignments requiring advanced knowledge and experience in insurance accounts receivable. • Assists as needed to perform other related duties and special projects as required.