Cycle Revenue Specialist - Medical Collections

We are seeking a proactive and detail-oriented Cycle Revenue Specialist - Medical Collections to join our dynamic healthcare revenue cycle team. In this vital role, you will manage the collection process for medical accounts, ensuring timely and accurate reimbursement from insurance providers and patients. Your expertise will optimize revenue flow while maintaining positive relationships with payers and patients alike.

Responsibilities include reviewing and analyzing denied medical claims involving DRG, CPT, ICD-10, and ICD coding; following up on unpaid or underpaid claims by communicating with insurance companies and patients; managing accounts receivable cycles prioritizing high-value or aged claims; collaborating with medical office staff to verify patient information and insurance details within EMR and EHR systems; maintaining detailed records of collection activities; and staying current with industry regulations and coding updates to ensure compliance and maximize reimbursement opportunities.

The ideal candidate has a minimum of 5 years experience in medical billing, collections, or revenue cycle management within healthcare, strong knowledge of medical terminology, records management, and coding systems (DRG, CPT, ICD-9, ICD-10), familiarity with EMR/EHR systems, excellent communication skills, and the ability to interpret complex medical documentation accurately. Prior experience improving cash flow while maintaining professional relationships is advantageous.