REVENUE CYCLE SPECIALIST

At Pueblo Medical Imaging, our Revenue Cycle Specialists play a vital role in supporting the financial health of our organization while helping ensure an exceptional patient experience. This position serves as a key liaison between our Revenue Cycle Management (RCM) vendor, providers, and internal teams to resolve billing issues, improve reimbursement, streamline workflows, and support compliance initiatives.

We are committed to excellence—not only in the care we provide to our patients, but also in the way we support one another. Our culture is built on teamwork, accountability, respect, and continuous improvement, creating an environment where employees are empowered to grow professionally and make a meaningful impact.

If you are detail-oriented, collaborative, and passionate about improving healthcare operations through effective revenue cycle management, Pueblo Medical Imaging offers an exciting opportunity to build your career while making a difference every day.

Position Summary

The Revenue Cycle Specialists serve as intermediaries between RCM Vendors, medical providers, patients and health insurance companies.  They function as a liaison, escalating issues and monitoring performance.

Key Responsibilities

1. Information and Documentation Support – Research and obtain missing information or documentation required for billing, claim submissions, or appeals to ensure timely and accurate revenue capture.
2. Vendor Communication – Utilize Smartsheet and other communication tools to collaborate effectively with the external RCM vendor (PMI or RAN) on account-specific issues, follow-ups, and documentation needs.
3. RCM Vendor Collaboration – Participate in weekly meetings with the RCM vendor to review payer issues, billing performance metrics, denial trends, and process improvement opportunities.
4. Staff Training and Communication – Educate and support authorization and scheduling teams regarding payer requirements that can be addressed proactively (e.g., Medicare exam timing, authorization rules, PECOS registration).
5. Record Retrieval – Retrieve and organize required documentation, such as physician orders, ABNs, or additional clinical notes, to support billing, audits, and compliance.
6. MIPS Support – Assist physicians in meeting MIPS program requirements by helping with portal submissions, developing or refining addendum templates, and streamlining documentation workflows.
7. Education and Training Participation – Attend and actively contribute to internal sessions on coding, documentation standards, MIPS updates, and other compliance initiatives.
8. Credentialing Assistance – Support credentialing and enrollment processes by maintaining up-to-date provider documentation (licenses, board certifications, signatures) and coordinating onboarding for new physicians.
9. Cash Reconciliation and Reporting – Review and reconcile daily, weekly, or monthly cash postings across all payer and patient accounts. Maintain a consolidated view of collections and variances, ensuring alignment between internal records and vendor reports.
10. Denial and AR Follow-up Oversight – Monitor denial trends, identify root causes, and collaborate with the RCM vendor to implement corrective actions. Track aged accounts receivable (AR) to ensure timely resolution.
11. Audit and Compliance Support – Assist with internal and external audits by compiling requested documentation, verifying billing accuracy, and supporting compliance initiatives.
12. Data Analysis and Performance Metrics – Assist with generating and reviewing RCM performance reports, highlighting key metrics such as clean claim rates, days in AR, and payer reimbursement patterns.
13. Team Development and Support – Train and mentor peers and new team members, fostering consistency and efficiency in revenue cycle processes.
14. Continuous Process Improvement – Identify workflow inefficiencies and propose solutions to improve revenue capture, reduce denials, and streamline collaboration with the RCM vendor.
15. Other Duties as Assigned – Perform additional tasks and participate in special projects to support department and organizational goals

• Two years previous billing experience. 
• Knowledge of Nevada insurance and Medicare/Medicaid regulations.
• Knowledge of laws on debt and collection.
• Knowledge of medical coding.
• Knowledge of medical terminology.
• Maintain confidentiality of all company and patient information at all times, as required by the facility and HIPAA guidelines.
• Must be able to perform essential job functions efficiently

• Ability to use excellent communications skills.
• Ability to manage stress appropriately.
• Ability to manage time efficiently.
• Ability to handle multiple projects and meet deadlines.
• Ability to work alone and/or with others effectively.
• Possesses common sense understanding to carry out instructions furnished in written, oral and diagram form.