Senior Revenue Cycle Specialist

• Engage daily with market leaders to obtain assistance with denials that require local assistance.
• Review and answer escalated emails from all IVX markets
• Facilitate review and submission of escalated appeals from Billing Manager or Follow-Up Team as needed
• Support Billing Managers by training new colleagues on follow-up processes to ensure proficiency in all required functions
• Review and obtain any additional clinical information (including but not limited to medical history, support for diagnosis, and letters of medical necessity) required to complete payer appeals
• Diligently review underpayment reports and collaborate with Billing team members to resolve
• Lead overpayment report review and refund submission to Accounting
• Communicate with insurance companies to resolve denials and obtain payment
• Work with Billing Manager to establish follow-up in new markets prior to handing over to assigned follow-up team member
• Facilitate collaboration calls with Prior Authorization, Contracting and Credentialing teams as needed to identify trends and resolve denials
• Investigate outstanding unpaid claims reports to include making sure new payers are set up for RTE, ERA and EFT with clearinghouse
• Assist with any denied claims needing Prior Authorization team intervention
• Assist with payer policy review for team members working on denials
• Assist Billing Manager with QA of payment posting, insurance/patient follow-up, coding, and financial counseling teams
• Demonstrate excellent customer service skills through patient-centered communications
• Contribute to departmental continuous improvement by recommending process improvements
• Take ownership of special projects, research data and follow through with detailed action plans as assigned by your manager
• Actively participate in problem identification and coordinates resolution between appropriate parties
• Perform duties and job functions in accordance with the policies and procedures established for the department.

• Proficiency with standard office software applications (Microsoft Office, Outlook, Teams, etc.)
• Excellent organizational, consultative, analytical, and problem-solving skills
• Ability to work independently under general supervision and effectively prioritize workload
• Ability to multitask and adapt to fast-paced work environment
• Takes initiative and capitalizes on all opportunities to improve department efficiency and effectiveness
• Strong interpersonal skills and ability to adjust communication style to match audienceAbility to collaborate and communicate at all levels of an organization
• Knowledge of basic medical terminology

• High School Diploma or GED required
• 2 Year / Associates Degree in Medical Office Managing, Medical Insurance, or Medical Coding strongly preferred
• 5-7 years’ experience working in full revenue cycle in a facility or physician office setting or similar role
• Certified Professional Coder or Certified Professional Biller is a plus

Pay is based on a number of factors including market location, job-related knowledge, skills, and experience, and is benchmarked against similar organizations to our size and industry. For our Senior Revenue Cycle Specialist role, we generally pay new hires between $26.00 and $27.50 per hour. It is not typical for an individual to be hired at or near the top of the range for roles and compensation decisions are dependent on the facts and circumstances of each situation. In addition to cash pay, full-time regular employees are eligible for 401(k), health benefits, and other company benefits; some of these benefits may also be available for part-time positions.