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Health First · 1 month ago

Revenue Cycle Specialist- Patient Business Services

Rockledge, FL

Full-time

Onsite

Entry Level

1+ years exp

Health First is a company that values diversity and inclusion in its workforce. The Revenue Cycle Specialist is responsible for managing third-party claims reimbursements, collaborating with various departments to enhance financial performance and ensure compliance with regulations.

Health CareHealth InsuranceHome Health CareHospitalMedical DeviceWellness

Responsibilities

Reviews and processes professional and institutional claims to ensure accurate and timely reimbursement

Investigates and resolves claim denials, underpayments, and payment discrepancies with third-party payers

Monitors and analyzes reimbursement trends, identifying issues that impact revenue and implementing corrective actions

Engages with insurance companies, government payers, and vendors to verify benefits, submit appeals, and secure payments

Updates and maintains patient accounts and billing systems with accurate payment and denial information

Communicates payer trends, delays, and discrepancies to leadership and assists in developing solutions

Ensures compliance with state, federal, and payer-specific regulations related to claim processing and reimbursement

Assists in the training and mentoring of new hires to ensure adherence to applicable department standards and processes

Collaborates with internal departments such as Coding and Documentation, Patient Financial Services, and Patient Registration to resolve claim issues and improve workflow

Promotes productivity and quality assurance benchmarks to support Revenue Cycle efficiency and financial goals