The Revenue Cycle Specialist will work in the health-related field and ensure the financial success of the hospitals or health care facilities. The tasks that are mentioned on the Revenue Cycle Specialist Resume are – ensuring long-term financial integrity of the hospital, handling patient data, executing key tasks within the revenue cycle, initiating billings and invoices, arranging for payment processes, overseeing accounts receivables and collections, properly accounting all services, and overseeing every aspect of payment and collections of the hospital.
Those interested in this line should basically have an extensive background in business, finance or other related fields. A bachelor’s degree and relevant work experience are required for this post. Apart from formal education, these skills are also expected – strong medical bill collection practice knowledge, a thorough knowledge of HIPAA rules, an in-depth knowledge of coding and billing; and a good understanding of insurance benefit plans.
Summary : Payment Application Rep/Revenue Cycle Specialist with a strong background in office administration, office procedures, and accounting functions. Strengths include budget management, critical analyses, flow processes, auditing, and training. Proficient with the use of Synergy, Etran, Artiva, Host, Medicaid, CMS Portal systems, CWF, Meditech, DEI, Document Direct, Auto Web, Health Quest, Self-Pay, HMS, Pro-Med, IDX Web base system, Availity, Revenue Cycle Pro, HPF, Emdeon, SSI, McKesson, Craneware, PFS and other various healthcare programs.
Skills : Management, ICD-9 ICD-10, Self Motivated Self-directed, Attention To Detail, Strategic Thinker And Problem Solver, Strong Organizational Skills, Excellent Verbal, Written, And Interpersonal Skills.
Description :
Report to the CFO, work seamlessly with the revenue cycle team as the primary resource for contracting, compliance and other issues that could prevent optimal revenue capture.
Handle contracting and registration with third-party payers including re-credentialing as well as all state registrations.
Administer electronic clearinghouse functions, conduct billing audits, coordinate outside vendors and audits, research and advise on CAQH and Medicare / Medicaid issues.
Respond to claim balance settlements and assist in staying current with system usage.
Maintain updated knowledge of health care billing procedures, documentation, regulations, and standards.
Maintain Medicaid contracts in 20+ states, Medicare contracts in 14+ states, Blue Cross / Blue Shield in 14+ states, and commercial contracts in 30+ states.
Spearhead a credentialing project to obtain more than 100 contracts with Medicare within a month.
Complete project obtaining contracts in less than a month.
Experience
10+ Years
Level
Management
Education
Bachelor Of Science
Revenue Cycle Specialist (Contractor) Resume
Headline : Meticulous, results-driven and quality-oriented Revenue Cycle Specialist, With an extensive background in computer software and customer service. Possesses the highest degree of integrity, supported by a flawless record of maintaining confidentiality. Excellent interpersonal and communication skills maintained by staying constantly connected.
Skills : ICD-9, ICD-10, CPT, HCPCS, Medical Terminology, Customer Service.
Description :
Processes all phases of the revenue cycle. Reviews demographic information, codes, charges, and corrects claims to meet specific payer requirements.
Uses critical thinking skills to bill services compliantly and question areas of uncertainty.
Obtains authorizations for services in accordance with payor contracts and regulatory guidelines and effectively communicates these authorizations with applicable staff.
Analyzes and performs efficient problem account activity research, identifies solutions and initiates appropriate course of action.
Acts as a resource for team members as wells a clinical staff ensuring coding practices fall within established compliance guidelines for ICD-9, ICD-10, and CPT codes.
Assigns appropriate revenue, procedure, and diagnosis codes after a thorough review of medical records, clinical visit notes, and resource materials.
Performs accurate daily processing of all coding and/or claims output, meeting agency/payor transmission deadlines.
Experience
5-7 Years
Level
Executive
Education
Bachelors of Science
Senior Revenue Cycle Specialist Resume
Summary : Seeking a position with a company that will allow to succeed in a challenging and stimulating work environment, use the skills and knowledge for organizational and personal growth, and provide advancement opportunities. Ability to work independently, while maintaining firm deadlines, sound analytical and problem-solving skills, managing numerous tasks and maintaining organization, interacting and explaining financial problems to individuals
Skills : Training, Supervisory Coordination, Quality Control Program Development, Medical Billing, Meeting Planning, Inventory Control, Budgeting, AP/AR
Description :
Monitors and analyzes accounts receivable to ensure maximum net revenue realization, stable cash collections, avoidance of denials and measured reduction to bad debt.
Achieve and maintain industry-leading Key Performance Indicators.
Ensures appropriate internal controls within the revenue cycle system.
Identifies and implements cost reduction and revenue improvement strategies.
Identifies and implements process and workflow improvements to increase efficiency and effectiveness.
Responsible for effectively managing patient complaints in a timely, professional and compassionate manner.
Responsible for effective collaboration with the management team in strategic planning, operations management, and implementation of company objectives and special projects.
Responsible for timely escalation of any issues that may have a significant impact or have the potential to significantly impact operations under your control.
Experience
10+ Years
Level
Consultant
Education
Bachelor Of Science
Junior Revenue Cycle Specialist Resume
Objective : Committed and motivated Junior Revenue Cycle Specialist with exceptional customer relations and decision-making skills. Expertise in managing system issues and ensuring the same are resolved, maintain detailed records of transactions made and managing international clients. Extensive experience in working under acute pressure & stress, equipped with systematic and exceptional problem-solving skills.
Responsible for claim submission and claim resolution for CCS Medical patients in regards to governmental, commercial insurance companies and patient accounts.
Worked on an individual portfolio of accounts from CCS Medical collection system Verified that all appropriate supporting documentation is obtained for Medicare Audits.
Identified problems or improvements within my own area while developing resourceful and alternative solutions for work process improvement and problem solutions.
Researched and conducted follow-ups on all correspondence associated with assigned accounts.
Managed calls to and from physician's offices to gather and track required documentation for accounts.
Responsible for documenting correspondence and activities as completely.
Provided resolutions where possible with account status and track progress while reporting any problems to the attention of Management if unable to resolve issues.
Experience
2-5 Years
Level
Junior
Education
Bachelor Of Science
Assistant Revenue Cycle Specialist Resume
Headline : To secure an appropriate position, this will provide growth opportunities with effective utilization of the skills and experiences also the opportunity to learn more in a professional atmosphere. Successfully took over new roles and responsibilities and delivered results within a short span of time.
Worked with all Hospital Faculty Practice Plan departments to ensure efficiency through office coverage and consistency in all front desk billing activities.
Identified and provided for the customers' needs using customer service standards.
Maintained confidentiality of all patient information.
Abstracted material from the patient's clinical records to facilitate proper billing.
Assisted in conducting training classes for the IDX billing application.
Responsible for partnering with providers and clinic operations staff to support the Revenue Cycle.
Ensured all services provided are accurately captured in the medical record, coded and billed appropriately. Responsible for implementing corrective action plans to improve revenue cycle outcomes. Provide coding education to providers and clinical staff.
Experience
5-7 Years
Level
Executive
Education
High School Diploma
Senior Revenue Cycle Specialist Resume
Summary : Driven, diligent Senior Revenue Cycle Specialist and effective team leader and a player with outstanding interpersonal skills. Flexible and adaptable with exceptional multi-tasking skills in a fast-paced work environment. Skilled at learning new concepts quickly, working under pressure, and communicating ideas clearly. Excellent problem-solving skills Strives to obtain an admirable work ethic and work very well independently or in a team setting.
Posted payments and denials in both billing systems.
Ran reports to track the productivity of the employees.
Traced payments for outstanding claims to see if the checks have been received and deposited.
Created a system to help better identify checks that come separate from their corresponding explanation of benefits so they can be matched up and applied to the account.
Generated new ideas on how to keep the office morale up but keep everyone focused and working diligently at the same time.
Helped to resolve payment mistakes made by us, the insurance company, or the patient.
Resolved missing payment issues by researching the check to see if it was deposited into any of the bank accounts and applying the money to the patient account if so.
Assumed the role as the go-to person for the patient call center to come to with any patient account issues or complaints due to payment errors of any kind.
Experience
7-10 Years
Level
Senior
Education
Bachelor Of Science
Revenue Cycle Specialist I Resume
Summary : Highly qualified and dedicated Revenue Cycle Specialist I, with solid knowledge and experience in the fields of Customer Service, Traveling Consulting, and Financial Reimbursement. A confident communicator with strong interpersonal & analytical skills who thrives on social interaction and customer satisfaction.
Skills : Microsoft Office, Ability, Microsoft Outlook, Cerner, Health PAS.
Description :
Proficient in Epic systems pulled denial database to work denials to send to the clearinghouse to scrub claims for real-time for proper reimbursement.
Reviewed the Patient Electronic Health Records through Epic for proper coding and reimbursement.
Ensured timely and accurate claim processing via electronic and paper submission.
Resolved denied claims in a timely manner, initiate contact with patients to obtain correct billing information for denied claims.
Submitted claims both electronically and paper to obtain proper reimbursement.
Maintained high levels of professionalism and productivity while multitasking.
Resolved billing errors and escalated issues to the proper department for additional follow-up.
Ensured patients accounts were thoroughly documented in the Billing Notepad system.
Experience
10+ Years
Level
Consultant
Education
Associates
Associate Revenue Cycle Specialist Resume
Headline : An enthusiastic, creative, goal-oriented Associate Revenue Cycle Specialist with expertise in customer service and quality control. Solutions-oriented, results-driven, ability to multi-task, excellent analytical and problem-solving skills; utilized to reach important milestones and exceed departmental goals.
Skills : Multi-line phone system, Strong front office skills, Patient care, Data Entry, Verifying patient's insurance, Account Receivables, Excellent customer service, Managerial, Type 50 WPM, Quick learner.
Description :
Monitors Quality Assurance related to job functions.
Detects and corrects edits claims prior to submission/transmission of claims, and verifies confirmation received on transmitted claims.
Applys coding conventions in order to resolve claim issues and discrepancies with medical necessity.
Responds to customer service phone calls, documents actions, and findings.
Makes calls to responsible parties to determine ability to pay accounts, making financial arrangements when appropriate.
Establishes payment arrangements or offers financial assistance, such as charity, Medicaid, government assistance.
Completes the assistance applications and reviews with established guidelines to approve or disapprove. Process daily electronic payer rejections.
Experience
5-7 Years
Level
Executive
Education
Master Of Arts
Lead Revenue Cycle Specialist Resume
Summary : A confident communicator with strong interpersonal & analytical skills who thrives on social interaction and customer satisfaction. Able to work well with others and lead a team and drive the decision-making process. Currently looking for a senior position and to join a company where success is rewarded and internal succession is always given priority.
Skills : ICD-9, ICD-10, CPT, HCPCS, Medical Terminology, Customer Service.
Description :
Expedites and maximizes payment of insurance medical claims by contacting third-party payers and patients.
Identifies patients accurately and assigns the patient a unique identification number.
Secures patient accounts in order to maximize reimbursements in a customer service-oriented fashion.
Maximizes the efficiency and accuracy of the collection process by upfront collection and maintaining bill hold reports.
Provides documentation in the patient's charts of general consent, information release, advanced care directives, and other requirements.
Contacts third-party payers and patients to determine the reason for non-payments or delays in payments of medical claims.
Assists with inquiries from outside parties regarding account status.
Experience
7-10 Years
Level
Senior
Education
Masters of Business Administration
Revenue Cycle Specialist/Executive Resume
Headline : o enhance the knowledge of organization and management within the healthcare field in order to secure a future position as an Office Manager. To succeed in an environment where growth and excellence can earn a standard which provides me job Satisfaction and self-development to achieve personal as well as organization goals.
Skills : Training, Supervisory Coordination, Quality Control Program Development, Medical Billing
Description :
Promptly and methodically resolve patient issues by clarifying discrepancies; researching and exploring alternative solutions, as well as escalating unresolved balances.
Assist with outstanding guarantor balances as well as insurance denials.
Document and update patient files, as well as prepare and file, corrected claims.
Utilize SharePoint for the interface of patient claims and outstanding balance statements as needed.
Continuously act to maintain a safe work environment for all employees.
Update accounts receivable database with new accounts or missed payments.
Key charges for surgeries and family practice, as well as manually input patient demographics.
Document each call with thorough minutes of clear and reliable data.
Experience
5-7 Years
Level
Executive
Education
Bachelors of Science
Revenue Cycle Specialist Resume
Summary : A Revenue Cycle Specialist with over 10+ years of experience in multiple roles across Client Servicing, Operations Management, Revenue Enhancement, Quality Assurance, and Team Management. A smart working professional with sound coordination, capable of delivering desired results, consistently adopting a systematic approach to attain business objectives.
Followed up on insurance claims and filing appeals.
Implemented warrant in-debt court cases within the office and maintained caseload.
Traced delinquent customers to new addresses via trace website Answered customer questions regarding problems with their accounts.
Persuaded customers to pay amounts due on credit accounts & damaged claims.
Resolved discrepancies in accounting records. Assisted in court hearings on behalf of the practice.
Identified revenue cycle problems and implement solutions for improvement.
Coordinated activities of staff responsible for charge capture, coding, charge entry, insurance follows up, reimbursement analysis, or other financial functions.
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