Role Description
The Revenue Cycle Training Specialist reflects the mission, vision, and values of ruralMED, adheres to the organizationโs Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, and regulatory standards. This role is primarily responsible for delivering external training to client facilities, with a focus on educating billing staff from foundational concepts through advanced revenue cycle processes. The Specialist will serve as a subject matter expert in billing, claims management, and payer requirements, while also supporting internal training initiatives and assisting with complex claims escalation. This role is client-facing and training-intensive, requiring a high level of expertise, professionalism, and adaptability.
Duties and Responsibilities
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Lead external training programs for client facility billing teams, including new implementations and ongoing education.
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Teach billing fundamentals from the ground up, including patient accounts, claim creation, charge capture, and reimbursement workflows.
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Deliver advanced training on claims follow-up, denial management, and claims escalation strategies.
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Provide hands-on instructions in Direct Data Entry (DDE) and other billing systems as applicable.
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Educate clients on Medicare, Medicaid, and commercial payer policies, including regulatory updates and compliance requirements.
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Serve as a subject matter expert and resource for client billing questions, issues, and workflow optimization.
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Partner with client leadership to identify knowledge gaps and develop targeted training plans.
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Assist with internal staff training, onboarding, and ongoing education initiatives.
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Support internal claims escalation efforts, including research, resolution strategies, and payer communication.
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Develop and maintain training materials, job aids, and curriculum tailored to client and internal needs.
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Collaborate with RCM leadership and quality teams to address trends identified through audits and performance metrics.
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Build strong relationships with clients to ensure training effectiveness and long-term success.
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Utilize various training methods (virtual sessions, live demonstrations, job shadowing, etc.) to enhance learning outcomes.
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Track and report on training effectiveness, competency, and client progress.
Qualifications
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Strong expertise in healthcare billing, including hospital and/or rural health clinic (RHC) or critical access hospital (CAH) environments.
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In-depth knowledge of Medicare and Medicaid billing rules and regulations, commercial payer policies, claims lifecycle and denial management, and Direct Data Entry (DDE) systems.
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Proven ability to teach both beginner-level and advanced billing concepts.
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Experience with claims, escalation, appeals, and payer communication.
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Strong presentation, facilitation, and communication skills (verbal and written).
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Ability to translate complex billing processes into clear, understandable training.
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Proficiency in Microsoft Office (Word, Excel, PowerPoint, Teams).
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Experience with EHR systems such as Meditech, CPSI, EPIC, and Cerner, and clearinghouses, such as SSI, Trubridge, and Inovalon.
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Knowledge of individual payer portals.
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Excellent critical thinking, problem-solving, and organizational skills.
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Ability to manage multiple priorities in a fast-paced environment.
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Strong interpersonal skills with the ability to build trust with both clients and internal teams.
Work Experience, Education and Certifications
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Minimum (5) five years of hands-on Critical Access Hospital and Rural Health Clinic billing experience required.
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Prior experience in training, education, or mentoring is strongly preferred.
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High School Diploma or GED required; college degree preferred.
Working Conditions and Physical Requirements
Travel Requirements