Revenue Cycle Management Specialist I
On-siteCarolina, Carolina, Puerto Rico
Job Summary
Conduct accurate medical coding and submit claims to insurance companies and government payers while monitoring claim status to resolve denials or rejections. Handle patient billing inquiries, explain charges, and assist with payment arrangements, then monitor accounts receivable to follow up on overdue payments. Ensure compliance with healthcare regulations and privacy laws throughout the revenue cycle process, analyze performance reports to track key indicators, and collaborate with stakeholders to optimize reimbursement. Requires a Bachelor's degree in healthcare administration or finance, proficiency in medical coding systems, and experience in revenue cycle management. Full-time position in Puerto Rico with competitive compensation and benefits.
Required Qualifications
- Bachelor's degree in healthcare administration, finance, or a related field
- Proficiency in medical coding systems (e.g., CPT, ICD-10), billing processes, and healthcare regulations (e.g., HIPAA, Medicare, Medicaid)
- Ability to analyze financial data, identify trends, and make data-driven decisions to optimize revenue cycle performance
- Strong verbal and written communication skills to interact effectively with patients, insurance companies, and internal staff
- Capacity to identify and resolve billing issues and denials in a timely manner
- Meticulous approach to ensure accuracy in coding, billing, and financial records
- Familiarity with healthcare management software, electronic health records (EHR), and billing systems
- Ability to regularly talk and listen
- Ability to frequently stand; walk; use hands to finger, handle or feel; and reach with hands and arms
- Ability to occasionally sit; climb or balance; and stoop, kneel, crouch or crawl
- Ability to frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds
- Close vision
- Distance vision
- Color vision
- Peripheral vision
- Depth perception
- Ability to adjust focus
Desired Qualifications
- Previous experience in revenue cycle management, medical billing, or healthcare financial services
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