Role Description
Rev Cycle Specialist II handles complex account follow-up, denials, and claims resolution, working more independently and applying advanced knowledge of payer rules and billing systems.
Qualifications
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GA HMFA Certified Patient Account Representative (CPAR) Certification (or must obtain within 6 months of hire)
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High School Diploma or GED
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Minimum 3 years hospital or professional billing/collections experience
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Strong understanding of payer policies, explanation of benefits interpretation, and patient accounting systems
Requirements
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Solid knowledge of Revenue Cycle functions, including registration, authorization, and insurance billing
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Personal computer proficiency to include all programs necessary to perform job duties and ability to toggle between systems efficiently
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Excellent listening and problem-solving skills with attention to details
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Excellent customer service skills and ability to remain calm and professional in stressful situations
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Excellent verbal and written communication skills
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Ability to work independently within guidelines
Essential Tasks and Responsibilities
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Review, resubmit, and follow up on complex insurance claims
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Perform detailed account research and update account information accurately
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Resolve denials and ensure adherence to payer contract requirements
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Maintain work queues and ensure timely resolution of accounts
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Provide support to teammates and cross-train in additional revenue cycle functions
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Demonstrate strong documentation, analytics, professionalism, and customer service
Physical Demands
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Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time
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Weight Carried: Up to 20 lbs, Occasionally 0-30% of time
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Vision: Moderate, Occasionally 0-30% of time
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Kneeling/Stooping/Bending: Occasionally 0-30%
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Standing/Walking: Occasionally 0-30%
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Pushing/Pulling: Occasionally 0-30%
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Intensity of Work: Frequently 31-65%
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Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding