Revenue Cycle Management Specialist

🔥 16 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

👻 Ghost score 12%

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Upward Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2010

🏥 Healthcare

⚕️ Healthcare Insurance

💰 Series C - Upward Health on 2025-01

Healthcare • Healthcare Insurance

Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Their clinical team treats physical, behavioral, and social health needs where patients need help, offering services from management of chronic conditions (e. g. , congestive heart failure) to behavioral health support and connecting patients with social services like medically tailored meals. They serve patients directly and partner with health plans and providers, emphasizing reduced emergency department visits, improved outcomes, and high patient satisfaction. Upward Health operates community-focused care teams including doctors, nurses, and community health workers, and promotes “Healthcare Comes Home” through house calls and transitions-of-care programs.

📋 Description

• Prepare and submit billing data and medical claims to insurance companies, ensuring accurate coding • Ensure patients’ medical information is accurate and up to date • Prepare bills, invoices, and document amounts due for medical procedures and services • Post payments to the system and review Electronic Remittance Advice (ERA) for accuracy • Alert the AR follow-up team of denials • Report trends in denied claims or payment discrepancies to management • Communicate with colleagues and health plan staff to troubleshoot denials, takebacks, and underpayments • Analyze ERA to resolve billing issues • Address patient inquiries using critical thinking and problem-solving skills • Explain insurance claims clearly and escalate complex issues as needed • Review the Open Work queue in Athena in conjunction with the billing cycle • Review the Correspondence Open Task Work queue for assignment and follow-up • Review and manage the Hold Bill/Alert Open Work queue for incomplete registrations • Report to the Revenue Cycle Manager

🎯 Requirements

• 2 years of experience in medical billing or a similar role • Solid understanding of billing software and electronic medical records (EMR); experience with Athena is a plus • Ability to multitask and manage time effectively in a fast-paced environment • Knowledge of ICD-10, CPT, and HCPCS codes • Associate degree or high school diploma • Experience with Athena or similar medical billing platforms (preferred) • Experience with Salesforce (preferred) • Proven experience in customer service, preferably in healthcare or financial settings (preferred) • Proficient in Microsoft Office, especially Excel (preferred) • Strong analytical and problem-solving skills • Ability to work independently and in a highly virtual environment • Strong interpersonal skills • Excellent written and oral communication skills • Strong work ethic and willingness to adhere to deadlines

🏖️ Benefits

• Upward Health Benefits (details provided via the employer’s benefits link)