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Aegis Sciences Corporation

Revenue Cycle Specialist I

Aegis Sciences Corporation, Nashville, Tennessee, United States, 37247

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Revenue Cycle Specialist I

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Aegis Sciences Corporation

The

Revenue Cycle Specialist I

is responsible for analyzing and optimizing the financial processes within a healthcare organization, including patient registration, billing, coding, claims submission, and collections, by identifying areas for improvement, monitoring key performance indicators (KPIs), and implementing strategies to maximize revenue while adhering to compliance regulations; essentially acting as a data-driven expert to streamline the revenue cycle and ensure accurate and timely payments from insurance companies and patients.

Responsibilities

Work closely with Revenue Cycle Business Analysts and Revenue Cycle Financial Analysts, including handling claims and related tasks.

Prepare Complex Medical Records requests and review documents for accuracy, completeness, and congruency

Interpret payer correspondence and determine next appropriate action

Submit carrier appeals and reconsideration requests in a timely manner based on SOPs, or suggest improvements to SOPs

Review and update line-item receipt posting (LIRP) as needed or handle other posting needs

Work assigned hold codes and determine next actions including, but not limited to, bad addresses, eligibility, and other denial reasons

Maintain accurate tracking of client and referring provider documentation and obtain missing documentation to ensure accuracy and completeness

Ensure all relevant claims and appeal documentation is uploaded into OnBase

Verify all identified insurance carriers for policy related to prior authorization requirements as needed for claims adjudication

Collaborate with Coding, Billing, Patient Access, and Cash Receipts Specialists as needed

Qualifications

High School diploma or GED required; Associate’s or Bachelor’s Degree in Business, Finance, or related discipline preferred

With a High School diploma, a minimum of three (3) years of experience performing revenue cycle processes in a hospital, laboratory, ambulatory surgery center, or large medical practice with a minimum of three (3) years in denials management required; With a Bachelor’s degree in Finance/Accounting, no experience required

Knowledge of ICD9, ICD10, CPT, and HCPCS coding strongly preferred

Strong working knowledge of Microsoft Office, including Excel and Outlook

Ability to take direction and follow Standard Operating Procedures with a high degree of accuracy

Strong attention to detail and the ability to work in a fast-paced, team-oriented environment with a focus on communication required

Aegis Sciences Corporation is an Equal Opportunity Employer

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