Full Cycle Revenue Management Specialist

Responsible for the timely and accurate submission of invoices to payers for all services and products provided. Evaluates payments received and applies them to patient accounts. Follows up with responsible parties to ensure timely and accurate payments, assists with billing and collection training, and completes second-level appeals to payers.

Key responsibilities include:

• Submitting timely, accurate invoices to payers for products and services provided
• Understanding contract terms and fee schedules for submitted invoices
• Correctly determining quantities and prices for drugs billed
• Verifying that services and products are authorized and supported by required documentation
• Ensuring invoices are submitted only for properly ordered and confirmed services and products
• Evaluating payments received for accuracy and applying them correctly to patient accounts
• Ensuring secondary bills and patient invoices are mailed within 48 hours of payment receipt
• Notifying the Reimbursement Manager of overpayments or duplicate payments
• Transferring payments belonging to other offices within 48 hours
• Following up on submitted invoices to ensure prompt payment
• Confirming claims were received and are processing
• Sending patient or responsible party letters when insurance does not pay in a reasonable time frame
• Generating and mailing statements and collections letters
• Following up on denials within 48 hours of receipt
• Maintaining compliance with contract terms, fee schedules, and HIPAA requirements