Revenue Cycle Specialist

Summary

Join MedScope, a division of Medical Guardian, as a Revenue Cycle Specialist! This full-time, remote position involves managing medical insurance claims using a customized system. You will submit invoices, process payments, resolve payment denials, and conduct monthly audits. Strong analytical and communication skills are essential. Permanent residency in specific states is required. The position offers competitive hourly pay and benefits.

Requirements

• Proficiency in the Microsoft Office suite of applications required
• Strong analytical and mathematical skills
• Intelligent individual with excellent oral and written communication skills
• Critical thinking - ability to decipher when things are missing or incorrect
• Accurate and organized with the ability to multitask
• Friendly phone demeanor - will be in direct contact with customers and referring sources
• Must be able to work both independently and collaboratively on a small team, and be accustomed to working with deadlines
• Punctual and reliable with a professional appearance and demeanor
• High school diploma required
• Permanent residency in one of the following states is required: PA, DE, GA, MI, NC, TX, NJ, and FL only

Responsibilities

• Monthly submission of invoices/claims, electronic and on paper, in large and small batches
• Payment application through our customized system
• Review and examination of non-paid invoices/claims, to work through the denial resolution process for resubmission or other appropriate resolution
• Month end reporting and analysis of accounts, large and small, including deciphering the reason(s) for invoices that are open and unpaid after aging for 90 days
• Audit accounts for payment and analyze the reason(s) that payment has been denied
• Phone work as needed, including customer interactions and receiving payments over the phone via credit card

Preferred Qualifications

• Associate or bachelor’s degree (preferred) in healthcare or a related field
• 1+ years of previous revenue experience
• Billing/coding certification preferred
• Coursework or experience with medical billing, 1500 claim forms, service authorizations, or previous experience with billing in a medical office
• Experience with Medicaid and Managed Care Organization a plus

Benefits

• Health Care Plan (Medical, Dental & Vision)
• Paid Time Off (Vacation & Public Holidays)
• Short Term & Long Term Disability
• Retirement Plan (401k)