About The Position

Rev Cycle Specialist II handles complex account follow-up, denials, and claims resolution, working more independently and applying advanced knowledge of payer rules and billing systems.

Requirements

  • GA HMFA Certified Patient Account Representative (CPAR) Certification (or must obtain with 6 months of hire)
  • High School Diploma or GED
  • Minimum 3 years hospital or professional billing/collections experience.
  • Strong understanding of payer policies, explanation of benefits interpretation, and patient accounting systems.

Nice To Haves

  • Solid knowledge of Revenue Cycle functions, including registration, authorization, and insurance billing.
  • Personal computer proficiency to include all programs necessary to perform job duties and ability to toggle between systems efficiently.
  • Excellent listening and problem-solving skills with attention to details.
  • Excellent customer service skills and ability to remain calm and professional in stressful situations.
  • Excellent verbal and written communication skills.
  • Ability to work independently within guidelines.

Responsibilities

  • Review, resubmit, and follow up on complex insurance claims.
  • Perform detailed account research and update account information accurately.
  • Resolve denials and ensure adherence to payer contract requirements.
  • Maintain work queues and ensure timely resolution of accounts.
  • Provide support to teammates and cross-train in additional revenue cycle functions.
  • Demonstrate strong documentation, analytics, professionalism, and customer service.
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