28 Revenue Cycle Specialist Jobs in Houston, TX
Houston Methodist is Hiring a Revenue Cycle Specialist Near Houston, TX
At Houston Methodist, the Revenue Cycle Specialist is responsible for providing direct and indirect revenue cycle support to the Revenue Cycle Managers. It is responsible for the timely coordination and completion of regulatory and/or revenue-enhancing special projects as identified by the Revenue Cycle Managers. In addition, the Revenue Cycle Specialist is responsible for resolving all outstanding third-party primary and secondary insurance claims for professional services. This Specialist is required to perform collections activities on complex denials and prepare complex appeals on outstanding insurance balances in the professional fee environment. This role is also responsible servicing as the subject matter expert in account follow-up. Also is responsible for providing information regarding complex denial trends for future prevention. The individual who holds this position exemplifies the mission, vision and values and acts in accordance with all HMH and PO CBO policies and procedures, including complying with The Houston Methodist Experience Service Standards.
- Collaborates with management to target complex claims and reduce aging of accounts by providing verbal and written communication.
- Assists with knowledge sharing, training payor and department cross training, and provides support to other team members as advised by the Manager and/or Supervisor.
- Identifies denial trends and notifies Supervisor and/or Manager to prevent future denials and further delay in payments. Collaborates with internal CBO departments and Account Managers to communicate and prevent denials. Provides suggestions for resolution.
- Completes special projects to improve team performance, as assigned.
- Demonstrates expertise and serves as the subject matter expert with all payers, including Medicare, Medicaid and commercial payers, and applicable department's revenue cycle operations. Provides coaching and support to projects related to collection efforts.
- Ensures protection of private health and personal information. Adheres to all HIPAA and PCI compliance regulations.
- Reviews third party payer work queues for complex payers and resolve accounts.
- Manages denials and appeals efforts. Creates and submits appeals when necessary.
- Resolves denials as they appear with actionable items that result in resolution. Engages the coding follow up team for any medical necessity or coding related appeals.
- Assures accounts are completed and worked at a high level of quality by visually proofreading and monitoring work output. Documents clear, concise and complete follow up notes in system for each account worked.
- Identifies, analyzes and escalates trends impacting AR collections.
- Expedites and maximizes payment of insurance medical claims by contacting third party payers and patients. This includes making outbound calls to payers and accessing payer websites.
- Reviews and assesses entire account to determine necessary steps or activity to resolve outstanding denials.
- Remains current on collection procedures of various payors and specialty departments.
- Assists with knowledge sharing, payor and department training, and provide support to other team members as advised by the manager and/or supervisor.
- High School diploma or equivalent education (examples include: GED, verification of homeschool equivalency, partial or full completion of post-secondary education, etc.)
- Assoicates Degree preferred
- Minimum five years' experience in commercial insurance follow-up
Job Summary
Full Time
Ambulatory Healthcare Services
$63k-84k (estimate)
03/27/2024
06/09/2024
houstonmethodist.org
CYPRESS, TX
7,500 - 15,000
2010
GABRIELA NICOLA
$5B - $10B
Ambulatory Healthcare Services
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The job skills required for Revenue Cycle Specialist include Customer Service, Managed Care, HIPAA, Communicates Effectively, Futures, Coordination, etc. Having related job skills and expertise will give you an advantage when applying to be a Revenue Cycle Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Revenue Cycle Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Revenue Cycle Specialist positions, which can be used as a reference in future career path planning. As a Revenue Cycle Specialist, it can be promoted into senior positions as a Revenue Cycle Manager that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Revenue Cycle Specialist. You can explore the career advancement for a Revenue Cycle Specialist below and select your interested title to get hiring information.
If you are interested in becoming a Revenue Cycle Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Revenue Cycle Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Revenue Cycle Specialist job description and responsibilities
A revenue cycle specialist oversees crucial financial tasks, specifically payment and collections, within a healthcare organization such as a hospital or clinic.
04/03/2022: Binghamton, NY
There are plenty of departments charged with making sure these things happen, but only a revenue cycle specialist oversees all of those departments.
02/26/2022: Saginaw, MI
Most revenue cycle specialist offer services like follow-up calls, past-due billing, and collections management.
03/27/2022: Madison, WI
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Revenue Cycle Specialist jobs
A certified revenue cycle specialist (CRCS) has passed an exam administered by the American Association of Health Care Administrative Management (AAHAM).
04/06/2022: Laramie, WY
Find out what a revenue cycle specialist does and how to become one.
04/11/2022: Springfield, MA
Step 3: View the best colleges and universities for Revenue Cycle Specialist.
