About the Opportunity
Our client on Long Island is seeking a skilled and dedicated Revenue Cycle Specialist to join their team! The right person in this role will take on a critical position, being responsible for managing the revenue cycle process, and specifically focusing on billing for their ambulatory surgery center and orthopedic services. This individual’s expertise in revenue cycle management and billing will contribute to the financial success of the organization and support their commitment to providing exceptional patient care.
The annual base salary range is $55,000 to $80,000. Actual compensation offered to the successful candidate may vary from posted hiring range based upon geographic location, work experience, education, and/or skill level, among other things. Details about eligibility for bonus compensation (if applicable) will be finalized at the time of offer.
Job Responsibilities
- Prepare and submit accurate claims for ambulatory surgery and orthopedic services, ensuring adherence to appropriate coding guidelines (CPT, ICD-10)
- Verify and enter charge information, including procedures, diagnosis, and modifiers, into the billing system, cross-referencing to ensure completeness and accuracy
- Manage the entire claims process, including electronic and paper submissions, and monitor the progress of claims through the revenue cycle
- Verify patient insurance coverage, including eligibility, benefits, and pre-authorization requirements for both ambulatory surgery and orthopedic procedures
- Post payments, adjustments, and denials accurately to patient accounts in a timely manner, reconciling with remittances received
- Monitor and follow up on unpaid claims and aging accounts, working collaboratively with payers and internal teams to resolve discrepancies and denials
- Address patient inquiries regarding billing, insurance, and account balances in a professional and patient-focused manner, providing clarity and resolution
- Generate and analyze revenue cycle reports for ambulatory surgery and orthopedic billing to identify trends, discrepancies, and areas for improvement
- Stay informed about billing and coding regulations specific to ambulatory surgery and orthopedic services, ensuring adherence to all applicable laws and regulations
- Collaborate with the revenue cycle team, clinical staff, orthopedic surgeons, and insurance providers to address billing and reimbursement issues
Job Requirements
- High school diploma or equivalent. Associate’s degree in healthcare administration or a related field is a plus
- At least 1 year of Revenue Cycle Management experience required
- Prior experience in revenue cycle management, billing, or medical office administration, preferably in an ambulatory surgery center or healthcare setting
- Knowledge of medical billing and coding procedures, including CPT and ICD-10 codes
- Knowledge of healthcare compliance regulations and a commitment to upholding ethical billing practices
