The Revenue Cycle Specialist I (RCS-I) is responsible for a variety of claims management functions including but not limited to supporting front-end revenue cycle and pre-billing functions. The RCS-I works under the direct supervision of the Accounts Receivable Manager. This role is responsible for ensuring patient accounts are complete, accurate, and ready for claim submission by verifying demographic information, insurance coverage, and required documentation. The RCS-I would be eligible for a hybrid remote work schedule at the completion of six months of successful employment.

Role and Responsibilities

Verify patient demographic data for accuracy and completeness.
Confirmanyinsurance coverage and eligibility.
Ensure required documentation is attached includingfacesheets, PCRs, and CMNs.
Perform pre-billing quality checks prior to coding and claim submission.
Identify missing or conflicting information androutefor correction.
Communicate with internal teams or facilities to obtain documentation.
Prepare accounts for coding and clean claimsubmission.
Manage inbound customer calls.
Maintain productivity and accuracy standards.
Adhere to all HIPAA regulations and compliance guidelines.
Demonstrate a strong commitment to workplace safety byidentifyinghazards, reporting risks, and supporting continuous safety improvements.
Adhere to all company safety policies, procedures, and regulatory requirements while actively promoting a safe and compliant work environment.
Collaborate with team members to uphold safety standards and foster a culture of safety across all operations.
Other duties as assigned.

Qualifications and Education Requirements

Must be 18 years old or older at time of hire
Graduation From High School or equivalent
Customer service experience
Ability to view computermonitorfor extended periods (more than 8 hours)
Ability to remain composed and multi-task in a busy, high-pressureenvironment.
Ability tocomprehendor learn department practices,rules,and regulationsquickly.
Ability tooperatetelephone and other specialized computer communicationequipment.
Ability to learn newsoftware.
Ability to speak clearly, concisely, andrespectfully.
Ability to communicate effectively with a diverse population, including medicalprofessionals.
Ability to think and react quickly and effectively in tensesituations.
Ability to follow written and oralinstructions.
Ability to recall details fromnumerousinformationalresources.
Ability to prioritize decisions based upon multiple criteria and identifiable standards of policies andprocedures.
Maintain a reliable attendance record and be punctualdaily.
Pass background investigation.
Pass a pre-employment drug screen and allsubsequentrandom or for cause drugscreenings.
Ability tolift upto 25 lbs.
Ability to speak, read,and write English

Preferred Skills

Medical officeand billing.
Knowledge of payor types – Medicare, Medicaid, private insurance
Proficiencyin Microsoft Office Suite

We'd love to have you join the WLRC Medical Team!

#HP

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