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Revenue Specialist

ncgCARE
Roanoke, VA Full Time
POSTED ON 4/10/2024

The role encompasses information management, including record management, subpoena response, and credentialing responsibilities. This involves both new and re-credentialing processes.

Essential Duties:

  • Denial Management: Analyze denied claims to identify reasons for denial. Promptly correct billing errors to maintain data precision.
  • Payer Outreach: Contacting payers to gather information on claim denials.
  • Process Improvement: Assist with implementing revenue-related processes and strategies to enhance operational efficiency. 
  • Collaboration: Collaborating with partner leadership, corporate leadership, the billing team, IT, and payers to resolve issues.
  • Credentialing: Collaborate with relevant partner-level staff to collect, submit, and/or verify required credentials. Initiate credentialing and re-credentialing processes for applicable clinical staff and maintain working status.
  • Information Management: Facilitate the release of medical records to authorized personnel, including clients, healthcare facilities, and insurance companies. Respond to subpoenas and court orders, ensuring accurate coordination and legal compliance. Uphold the highest standards of privacy, security, and legal requirements, particularly within the scope of HIPAA.
  • Facility: Support facility licensing and enrollment process.
  • Contracts: Support the contract management process.
  • Teamwork: Foster close teamwork for a cohesive and cooperative approach to achieving optimal financial performance.
  • Reporting: Contribute to regular reporting on key performance indicators (KPIs) related to revenue processes.
  • Meetings: Attend and actively contribute to staff meetings within the Revenue Operations team.
  • Training: Attend relevant training to stay updated on industry best practices, regulatory changes, and emerging trends.

Salary.com Estimation for Revenue Specialist in Roanoke, VA
$76,811 to $97,975
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