Revenue Cycle Specialist

Align ENT & Allergy is currently seeking a detail-oriented and experienced Revenue Cycle Specialist to join our team. As a physician-led ENT and Allergy practice management company, Align ENT & Allergy provides business support to private practices through a true partnership model. In this role, you will be responsible for managing various aspects of the revenue cycle process, including Insurance Verification, Prior Authorization, Commercial Insurance Cash Posting, and Commercial Insurance Accounts Receivable Resolution. The ideal candidate will have a minimum of six months of experience with eClinicalWorks and a strong understanding of revenue cycle operations within a healthcare setting.

Responsibilities

• Perform insurance verification for patients scheduled for appointments, ensuring accuracy of patient benefits and completeness of information
• Obtain Prior Authorizations for medical services and procedures, adhering to payer requirements and timelines
• Manage healthcare billing processes, including claim creation, submission, and follow-up
• Submit claims to insurance companies electronically or via paper submission
• Monitor and track claim status for timely reimbursement
• Conduct follow-up on outstanding insurance accounts receivable to resolve unpaid claims and minimize aging of accounts
• Review and analyze denied claims, identify trends, and implement strategies to reduce denials
• Collaborate with insurance companies and patients to resolve billing inquiries and disputes
• Process Commercial Insurance Cash Posting accurately and efficiently, reconciling payments against outstanding accounts
• Collaborate with the billing team to address any coding or billing discrepancies that may impact reimbursement
• Stay up-to-date with coding and billing regulations and guidelines
• Provide training and support to staff regarding revenue cycle processes
• Communicate effectively with patients, insurance companies, and internal stakeholders to resolve billing inquiries and disputes

Requirements

• Minimum of 3 years of experience in revenue cycle management or medical billing
• Minimum of six months of experience working with eClinicalWorks
• Strong understanding of medical coding (ICD-10, CPT) and billing processes
• Experience with insurance claim submission and reimbursement
• Excellent attention to detail and analytical skills
• Strong problem-solving and decision-making abilities
• Excellent communication and interpersonal skills
• Ability to work independently and collaboratively in a team-oriented environment

Benefits

Pay to commensurate with experience.

Benefits:

401(k)

• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

Day shift

• Monday to Friday