AP Health · 3 days ago
Revenue Cycle Specialist I
Nashville, TN
Full-time
Hybrid
Entry Level
1+ years expAP Health is focused on ensuring compliance and financial health in patient care, and they are seeking a Revenue Cycle Specialist I. This role involves managing the administrative and financial aspects of patient care, including claims submission, insurance verification, and communication with patients regarding billing matters.
Health CareStaffing AgencyTraining
Responsibilities
Support accurate data entry and insurance verification as needed to ensure claims are billed and paid in a timely manner
Maintain general understanding of diagnosis and procedural coding rules to effectively follow up on claims and resolve issues
Communicate with patients to verify insurance details, inform them about their billing statements, and answer any questions about medical charges
Ensure all claims are submitted accurately and in compliance with healthcare laws to insurance carriers, Medicare, Medicaid, and other payers using various electronic systems
Complete claims follow up as necessary on billed claims, by communicating directly with insurance carriers via phone, payer portals, and written correspondence to clarify denial reasons, obtain claim status updates, and advocate for appropriate reimbursement
Support the payment process, including generating patient billing statements, assisting patients with payment plans, tracking payments from insurance companies and patients, and applying payments to the appropriate accounts
Research and resolve claim denials, underpayments, and any coding-related issues
Participate in process improvement initiatives to increase efficiency
Collaborate closely with coding, billing, and clinical teams to obtain, review, and submit supporting medical documentation, physician statements, and claim corrections as needed to resolve claims
Stay up to date on all federal and state regulations, as well as specific insurance company guidelines
Maintain detailed documentation of all claim actions, payer communications, and appeal outcomes to support audits and reporting
Qualification
Required
1 – 2 years of charge entry and medical billing experience
Strong proficiency in Microsoft 365 (Outlook, Word, Excel, Teams, etc.), with the ability to quickly adapt to new tools and systems
Working knowledge of medical billing processes, claim life cycles, and payer reimbursement
Familiarity with CPT, ICD-10, and HCPCS coding concepts
Experience using electronic health record (EHR) and/or medical billing software
Excellent verbal and written communication skills
Exceptionally proactive, organized, and detail oriented
Company
AP Health
AP Health is a staffing agency that provides trained and professional medical providers to hospitals and surgical clinics.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
J. Toby Gray
CEO
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