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We are looking for a Revenue Cycle CS Specialist to support healthcare revenue operations in Henrico, Virginia. This Long-term Contract opportunity is ideal for someone who can manage patient account follow-up, resolve reimbursement issues, and work across billing and insurance processes with accuracy and urgency. The role focuses on improving cash flow by addressing outstanding balances, researching claim issues, and pursuing timely resolution of denials and appeals.
Job Responsibility
Review outstanding patient and payer balances, investigate account discrepancies, and take appropriate action to secure payment
Manage medical collections activities by contacting insurance carriers and other payers to follow up on unpaid or underpaid claims
Examine billing records and claim details to identify denial trends, correct issues, and support clean claim resubmission
Prepare and submit appeals with supporting documentation to challenge inappropriate claim denials and reimbursement reductions
Use eClinicalWorks to document account activity, update claim status, and maintain accurate records for follow-up actions
Coordinate with internal billing, coding, and customer support teams to resolve payment barriers and streamline account resolution
Monitor insurance responses, interpret explanation of benefits information, and determine next steps for reimbursement recovery
Prioritize high-value and time-sensitive accounts to help reduce aging receivables and improve collection performance
Requirements
Experience handling medical collections within a healthcare revenue cycle or billing environment
Working knowledge of medical billing processes, payer guidelines, and insurance follow-up procedures
Ability to research medical denials, identify root causes, and complete effective appeals submissions
Familiarity with medical insurance terminology, claim adjudication, and explanation of benefits review
Hands-on experience using eClinicalWorks or a comparable practice management or electronic health record system
Strong attention to detail with the ability to manage multiple accounts and deadlines accurately
Effective written and verbal communication skills for interacting with payers and internal stakeholders