Revenue Cycle Specialist
Emory Healthcare/Emory University
Atlanta, GA
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JOB DETAILS
SALARY
LOCATION
Atlanta, GA
POSTED
17 days ago
Overview
Be inspired. Be valued. Belong. At Emory Healthcare
At Emory Healthcare we fuel your professional journey with better benefits, valuable resources, ongoing mentorship and leadership programs for all types of jobs, and a supportive environment that enables you to reach new heights in your career and be what you want to be. We provide: + Comprehensive health benefits that start day 1 + Student Loan Repayment Assistance & Reimbursement Programs + Family-focused benefits + Wellness incentives + Ongoing mentorship, development, leadership programs + And more
Description
The Revenue Cycle Specialist is responsible for managing all aspects of the revenue cycle, including the resolution of patient claims, ensuring accurate billing, and maximizing reimbursement. This role serves as a patient advocate, supports financial processes, and contributes to overall operational efficiency and quality improvement.
RESPONSIBILITIES
Revenue Cycle & Claims Management
+ Manage patient accounts across the full revenue cycle, ensuring timely resolution of all claims. + Verify, research, and complete required documentation to submit claims for reimbursement. + Analyze payments, identify variances, and resolve complex reimbursement issues. + Ensure compliance with payer requirements, including pre-certifications and claim splitting. + Maintain knowledge of managed care contracts and apply terms to billing and reimbursement processes.
Patient Financial Services
+ Update and maintain accurate patient demographic and insurance information. + Communicate financial policies to patients clearly and effectively. + Identify patients needing financial counseling and provide appropriate resources. + Support patients during and after care with billing, collections, and financial assistance. + Serve as a patient advocate throughout the lifecycle of the account.
Account Follow-Up & Collections
+ Collect and follow up on assigned accounts before, during, and after admission/discharge. + Perform account reconciliation and ensure timely reimbursement. + Resolve financial issues related to patient accounts using analytical and problem-solving skills.
Collaboration & Workflow Support
+ Work closely with leadership to improve departmental workflows and processes. + Assist with departmental operations and workflow needs as required. + Serve as a resource and point of contact for staff questions. + Support training and development of new team members.
Quality Improvement & Reporting
+ Identify issues impacting revenue and notify leadership with recommended solutions. + Contribute to quality assurance initiatives by reporting trends, denials, and improvement opportunities. + Participate in education sessions and insurance payer forums to stay current on industry standards.
Specialized Knowledge & Compliance
+ Maintain working knowledge of: + Insurance and reimbursement processes + Referrals and authorizations + Electronic Medical Records (EMRs) and financial systems + Understand billing requirements for specialized services, including: + Transplants + Hospice + Infusions + Rehabilitation + Centers of Excellence + (If applicable) Maintain knowledge of transplant care standards and donor/recipient phases.
General Responsibilities
+ Operate effectively in a high-volume environment with heavy phone and computer usage. + Demonstrate professionalism, organization, and strong communication skills at all times. + Work independently while managing multiple priorities. + Perform additional duties as assigned.
Required Skills & Competencies
+ Strong analytical and problem-solving abilities + Excellent verbal and written communication skills + Proficiency in EMR systems, payer systems, and financial tools + Ability to interpret and apply managed care contracts + Strong organizational and time management skills + Ability to work independently and collaboratively
MINIMUM QUALIFICATIONS
+ Bachelor’s degree with two (2) years of relevant experience;
OR
+ Any equivalent combination of education and experience
Physical Requirements
Medium Work (Maximum 25 lbs):
+ Lifting: + Up to 25 lbs occasionally (0–33% of the workday) + 11–25 lbs frequently (34–66% of the workday) + 1–10 lbs constantly (67–100% of the workday) + Carrying objects up to 25 lbs
Work Activities:
+ Occasional to frequent standing and walking + Occasional sitting + Frequent close visual work (computer use, typing, reading, writing) _Note: Physical demands may vary depending on assigned work area and specific job tasks._ ENVIRONMENTAL FACTORS: Factors affecting environment conditions may vary depending on the assigned work area and tasks. Environmental exposures include, but are not limited to: Blood-borne pathogen exposure Bio-hazardous waste Chemicals/gases/fumes/vapors Communicable diseases Electrical shock, Floor Surfaces, Hot/Cold Temperatures, Indoor/Outdoor conditions, Latex, Lighting, Patient care/handling injuries, Radiation, Shift work, Travel may be required. Use of personal protective equipment, including respirators, environmental conditions may vary depending on assigned work area and work tasks.
Additional Details
Emory is an equal opportunity employer, and qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or other characteristics protected by state or federal law. Emory Healthcare is committed to providing reasonable accommodations to qualified individuals with disabilities upon request. Please contact Emory Healthcare’s Human Resources at careers@emoryhealthcare.org . Please note that one week's advance notice is preferred.
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Division
_Emory Healthcare Inc._
Campus Location
_Atlanta, GA, 30345_
Campus Location
_US-GA-Atlanta_
Department
_EHI Precert_
Job Type
_Regular Full-Time_
Job Number
_160679_
Job Category
_Revenue Cycle & Managed Care_
Schedule
_8a-4:30p_
Standard Hours
_40 Hours_
Hourly Minimum
_USD $21.88/Hr._
Hourly Midpoint
_USD $26.66/Hr._ Emory Healthcare is an Equal Employment Opportunity employer committed to providing equal opportunity in all of its employment practices and decisions. Emory Healthcare prohibits discrimination, harassment, and retaliation in employment based on race, color, religion, national origin, sex, sexual orientation, gender identity or expression, pregnancy, age (40 and over), disability, citizenship, genetic information, service in the uniformed services, veteran status or any other classification protected by applicable federal, state, or local law.
About the Company
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