• The Revenue Cycle Specialist is responsible for reviewing and processing claims in various stages of the revenue cycle in a timely and compliant manner
• Monitor overall client performance, identify potential loss or delay in revenue to ensure maximized reimbursement for assigned clients
• Initiate timely and proactive communication to payers to identify deficiencies and provide appropriate feedback to operational staff in order to resolve and prevent issues
• Prioritize, process, and delegate correspondence, rejections, denials, appeals, static claims, and all other follow up on claims in accordance with compliance standards and payer and client specifications
• Work independently to define problems, identify causes, and initiate steps necessary for resolution in a timely manner
• Regularly meet, and effectively communicate with, Supervisor Claims Management, onshore and/or offshore team members to ensure highest level of reimbursement is achieved
• Holistically approach client performance by utilizing big picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow though
• Monitor and measure client performance outcomes in comparison to client commitments; identify barriers, seek and suggest solutions when desired outcomes are not achieved
• Stay abreast of industry changes and regulations to ensure adherence and proactive preparedness
• Exhibit strong customer service skills to build and maintain internal and external relationships in order to best address client needs.
