Our Revenue Cycle Specialist directly contributes to our mission by timely and accurately billing the services we provide, collecting revenue, and working with families to make sure they feel supported throughout the billing process.
This is a hybrid role based in King of Prussia, PA, with in-office work Tuesday through Thursday and remote on Mondays and Fridays. Candidates must be local to the King of Prussia, PA area.
SPECIFIC RESPONSIBILITIES:
- Own a defined book of business within accounts receivable, proactively identifying payer behavior patterns, validating correct reimbursement, and driving resolution to optimize revenue performance.
- Denial response and accounts receivable follow up via Waystar and insurance portals
- Commercial and Medicaid, primary and secondary claims submission
- Work and manage claims from all aging buckets from initial billing through final resolution including identifying and correcting billing errors/rejections and denials
- Denial management investigations & appeals
- Escalation at plan level to further understand processing and denials
- Identify trends on a plan/insurance level and escalate to leadership timely
- Input & Review billing data for accuracy, including data entry.
- Ensure that billing and collections adhere to all compliance policies and procedures.
- Follows up on claim resolution from initial billing through final
- Stay up to date on current payor processes and guidelines
- Other responsibilities as assigned by the billing manager and director
Skills and Competencies:
- 5+ years billing experience required.
- Central Reach, ABA, and/or previous remote experience required for remote work.
- Associate Degree in Accounting/Finance Management is plus, but not required.
- Strong communication and presentation skills are important.
- Strong critical-thinking skills and self-motivation (addition – may move to personality?)
- Previous patient admission or verification experience required.
- Confident communication skills for fielding calls on behalf of the agency and its representatives.
- Excellent written communication skills for professional emails and various reporting methods.
- Experience working with PA Medicaid payors a plus
Personality: A successful Team Member will be…
- Detail-oriented & highly organized
- Communicative & collaborative
- Committed to purposeful care
- Ambition to grow with the company
$22—$26 USD
