Medical Revenue Cycle Specialist

• Associate's or Bachelor's Degree in Healthcare Administration, Finance, Accounting, Business Administration, or a related field preferred.
• Valid Arizona DPS Level I Fingerprint Clearance Card required and must be maintained throughout employment

Experience Requirements

• Minimum 3 years of healthcare revenue cycle, medical billing, accounts receivable, or payment posting experience.
• At least 2 years of experience with claims processing, denial management, reimbursement reconciliation, cash posting, or insurance billing.
• Experience with EHR systems, ERAs, EFTs, EOB processing, and healthcare reimbursement preferred.
• Prior experience training staff, conducting quality reviews, or supporting workflow improvements is a plus.

Physical Capabilities

• Ability to sit, work on a computer, and review electronic records for extended periods.
• Strong attention to detail and analytical problem-solving skills.
• Ability to manage multiple priorities, deadlines, and high-volume workloads.
• Effective communication and collaboration skills in a fast-paced healthcare environment.

Job Duties

• Coordinate and oversee daily medical billing, claims submission, cash posting, payment reconciliation, and accounts receivable activities.
• Monitor claim rejections, insurance denials, underpayments, and aging AR; research issues and submit appeals or corrected claims as needed.
• Review remittances, EOBs, ERAs, refunds, recoupments, and payment variances to ensure accurate reimbursement and revenue integrity.
• Serve as the primary resource for complex billing, posting, and reimbursement issues while supporting revenue cycle staff with training and workflow guidance.
• Assist with EHR optimization, process improvements, compliance initiatives, and revenue cycle performance goals.
• Conduct quality audits, maintain HIPAA-compliant documentation, and ensure adherence to payer requirements, healthcare regulations, and organizational policies.
• Collaborate with billing, finance, and revenue cycle teams to improve cash flow, reduce denials, increase clean claim rates, and maximize reimbursement.