Medical Billing Specialist - Revenue Cycle Management

The Revenue Cycle Account Specialist is responsible for executing day-to-day revenue cycle functions for assigned client accounts, ensuring accurate, timely, and compliant processing across all billing activities. This role serves as a primary point of contact for clients while managing tasks such as charge entry, claims submission, payment posting, denial follow-up, and accounts receivable resolution.

The position supports the financial health of client accounts by maintaining workflow efficiency, resolving routine issues, and adhering to established billing guidelines and performance standards. It requires strong attention to detail, effective communication, and a solid understanding of revenue cycle processes to ensure high-quality service and client satisfaction.

What you will do

• Serve as the primary liaison between RCM and the client.
• Build team relationships with physicians, practice administrators, and office staff.
• Manage assigned accounts to ensure timely and accurate completion of revenue cycle tasks in alignment with established benchmarks and KPIs.
• Handle charge processes.
• Post ERA and paper payments timely and accurately.
• File claims electronically or on paper as required.
• Monitor clearinghouse reports for claim confirmation and acceptance.
• Work rejected claims received via the clearinghouse.
• Research and resolve denied and outstanding claims, identifying trends and escalating issues as appropriate.
• Clean up outstanding accounts receivable and maintain division benchmarks.
• Generate patient statements.
• Process patient and insurance refunds.
• Complete month-end processing and reporting.
• Identify and escalate complex issues or trends to leadership for review and resolution.
• Follow client-specific workflows and billing guidelines to ensure consistency and compliance.
• Resolve issues in a timely manner to prevent escalation to management.
• Manage patient, insurance, and client inquiries promptly while maintaining a high level of customer service.
• Assist with billing system maintenance as required.
• Follow company policies, procedures, and protocol, and report compliance issues.
• Adhere to HIPAA regulations and keep patient information confidential and protected.
• Participate in educational opportunities.
• Follow client-specific workflow schedules.
• Perform duties in a timely manner as required by clients and the company.
• Perform other duties as assigned.