Job Description
Revenue Cycle Reimbursement Specialist Position Overview: Reporting to the Director of Reimbursement, the Revenue Cycle Specialist is responsible for managing and resolving outstanding claims to achieve maximum reimbursement. This role requires strong knowledge of medical collections, accounts receivable, insurance billing and verification, denial management, appeal submission, and EOB review. Res
7:30 AM
Log in and pull the overnight denial queue. Your worklist shows 40–80 claims flagged by the payer in the last 24 hours. Sort by do…
8:00 AM
Start working the queue. For each denial, you're reading the remittance advice, identifying the denial reason code (CO-4, CO-50, C…
9:30 AM
Hit a complex medical necessity denial from a Medicare Advantage plan. Open the patient chart, pull the clinical documentation, an…
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