Revenue Cycle Claims Specialist
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Job Description
Revenue Cycle Claims Specialist optimizing revenue cycle operations for autism care providers at Finni Health. Collaborating with teams to enhance billing, claims processing, and compliance.
Responsibilities:
- Play a critical role in optimizing our revenue cycle operations
- Monitor claims approaching timely filing limits and alert the RCM team about these claims
- Resolve payer claims rejections by researching the root cause, calling the payer, and ultimately get claims accepted
- Follow up on claims with no payer response and ensure claims are on file with payers
- Identify root cause of issues and work with various teams to obtain updated coverage information
- Research root cause of claim denials and appeal them within deadlines
- Ensure all EDI related enrollments are in place with payers
- Ensure strict adherence to payer regulations and internal policies
- Lead workflow optimization initiatives within RCM and manage specific projects
- Collaborate extensively with multiple teams to align RCM efforts with business objectives
Requirements:
- 5+ years of relevant experience in revenue cycle management
- Strong understanding of RCM processes, including billing, claims, collections, denial appeals, and accounts receivable management
- Proven ability to work effectively within a team environment
- Excellent written and verbal communication skills
- Proficiency in Google Suite, Slack, CRM/support software, and EHR/RCM management tools
Benefits:
- Health insurance
- Flexible work arrangements
- Professional development opportunities
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