Revenue Cycle Specialist - Healthcare
Job Type
Full-time
Description

Join our team and make a meaningful impact behind the scenes of patient care. We are seeking a Revenue Cycle Specialist to support our Hospice and Palliative billing operations. In this role, you will play a key part in the revenue cycle process—handling claim preparation, data validation, payment posting, and payer follow-up—while maintaining strict compliance with Medicare, Medicaid, and other payer requirements.


Responsibilities:

  • Ensure accurate hospice and palliative billing by verifying patient accounts, charges, payer assignment, and timely application of payments.
  • Review and validate Medicare/Medicaid documentation including certifications, re-certifications, Face-to-Face attestations, and timely submission and acceptance of Notices of Election (NOEs).
  • Submit and monitor electronic claims in compliance with payer requirements, addressing internal edits, rejections, and denials promptly.
  • Perform accounts receivable follow up activities, including monitoring claim status, researching routine denials, reviewing aging reports, and escalating complex issues as appropriate.
  • Assists with room and board billing and facility invoicing, including flagging PDPM or regulatory issues for review, invoice review, and coordination with Accounts Payable.
  • Support patient and facility billing needs and compliance by preparing statements, managing refunds and follow-ups, staying current on regulations, and assisting with special billing projects.
  • Supports billing operations and departmental objectives by collaborating with internal and external stakeholders, participating in meetings, QAPI initiatives, and maintaining a productive work environment.
  • Demonstrates professionalism, customer focus, and compliance by building positive relationships, safeguarding patient and agency confidentiality, and adhering to HIPAA and organizational standards.

Essential Skills for Success:

  • Strong attention to detail.
  • Ability to follow established billing procedures and workflows.
  • Basic understanding of healthcare billing, with willingness to learn Medicare, Medicaid, and hospice regulations.
  • Organizational and time management skills.
  • Professional verbal and written communication skills.
  • Ability to recognize routine billing issues and escalate complex matters appropriately.
  • Proficiency in EMR and billing systems with accurate data entry and record maintenance.

Qualifications:

  • High school diploma or GED required, Associate's or Bachelor’s degree preferred. 
  • One or more years relevant billing experience. 
  • Proficiency in processing billing and posting remittance advices required. 
  • Must have good organizational skills, excellent verbal and written communication, comprehensive computer and interpersonal skills with proficiency in Microsoft Office applications.

Preferred Qualifications:

  • Hospice and provider billing experience. 
  • Medicare/Medicaid billing experience.
  • Office management/accounts receivable background within an accounting office setting.

Typical Physical Demands/Working Conditions:

  • Sit, stand, stoop, bend, reach, lift and walk, climb steps.
  • Communicate by phone, writing, and speaking.
  • Extended periods of sitting, desk-bound activities.
  • Lifting up to 20 pounds.


Hospice of the Piedmont offers competitive wages and a comprehensive benefits package which includes Medical, Dental, Life, Short & Long Term Disability, 403(b) and Roth Retirement Plans with employer matching, Flexible Spending Accounts, Employee Assistance Program, Paid Time Off, and Paid Holidays.


Hospice of the Piedmont is a non-profit, equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees and patients served.