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Revenue Management Specialist in Spartanburg, SC at Spartanburg Regional Healthcare System

Date Posted: 5/4/2019

Job Snapshot

  • Employee Type:
    Full-Time
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    5/4/2019

Job Description

Job Summary
The AR management specialist works with unique department billing/collection functions to assure accounts are managed accurately and timely. Responsibilities will vary based on department need.  Duties to include-

  • Responsible for research and resolution of all outstanding patient and insurance credit accounts, any additional A/R management research and account updates required to ensure claims are filed to the appropriate carrier or posted correctly. 
  • Processing of all refunds or credit reversals in a timely manner as defined within the departmental credit/refund policy/procedures. 
  • Responsible for all government monthly credit reporting preparation and requirements
  • Responsible for accurate charge capture, charge review, claim edits, posting to the AR system and resolution of all charge edits.
  • Responsible to handle all denials related to charge capture for improved integrity of charge capture
  • Responsible to accurately update patient demographics, insurance registration information, verification of insurance, etc. 
  • Responsible for the consolidation of duplicate guarantor/patient accounts within the AR management system in an accurate/timely manner. 
  • Responsible for the review and processing of Accounts Receivables reports to ensure revenue integrity.  Reporting trends identified during the analysis.
  • Assist with payer/physician credentialing and system table management.
  • Responsible for electronic remittance, eligibility and claims agreements to insure the proper processing of electronic transactions, electronic remittance requirements and other payer requirements for billing.
  • Responsible for all account financial changes and refiling of those claims to the appropriate payer source. 
  • Responsible for the processing of all vendor claim updates, returns and resubmissions for payment.  Other duties as assigned.

Education and Experience Requirements

High School diploma or GED required.  
A qualified applicant must possess:

  • 4 years medical office or medical-billing in a hospital or physicians billing setting, collections or coding experience. 
  • Strong knowledge of CPT, HCPCS and ICD-9/10 codes. 
  • Efficiency in reading insurance explanation of benefits (EOB) and understanding of remittance and remark codes.
  • Good working knowledge of Microsoft Excel 
  • Good communication skills and the ability to interact well with multiple departments/levels of management.


The preferred candidate would possess:

  • In depth knowledge of  all payer billing and eligibility requirements
  • One or more of the following certifications or like certifications-Certified Procedural Coder (CPC)(CPC-H),Certified Medical Insurance Specialist (CMIS), Registered Health Information Technician (RHIT), Certified Revenue Cycle Associate