Revenue Cycle Specialist

EMS Management & Consultants, Inc.

Revenue Cycle Specialist reviewing and processing health insurance claims for optimal reimbursement. Collaborating with operational teams to ensure compliance and maximize client performance.

Posted 7/10/2026full-timeRemote • 🇺🇸 United StatesJuniorMid-Level💰 $18 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in processing health insurance claims and denials while ensuring compliance with HIPAA regulations and payer requirements. Exhibits strong analytical skills and a holistic approach to client performance, focusing on maximizing reimbursement and continuous improvement.

Highest-signal resume keywords

Health Insurance Claims ProcessingHIPAA Regulations UnderstandingCritical Thinking and Analytical SkillsMicrosoft Office ProficiencyClient Performance Analysis

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingMedical BillingDenial ManagementAccounts ReceivableCompliance Adherence

Soft Skills

Customer Service SkillsOrganizational SkillsMulti-tasking AbilityAdaptabilityCommunication Skills

Industry Keywords

MedicareMedicaidInsuranceTertiary Payment MethodsLean Thinking

About the role

Key responsibilities & impact

The Revenue Cycle Specialist is responsible for reviewing and processing claims in various stages of the revenue cycle in a timely and compliant manner
Monitor overall client performance, identify potential loss or delay in revenue to ensure maximized reimbursement for assigned clients
Initiate timely and proactive communication to payers to identify deficiencies and provide appropriate feedback to operational staff in order to resolve and prevent issues
Prioritize, process, and delegate correspondence, rejections, denials, appeals, static claims, and all other follow up on claims in accordance with compliance standards and payer and client specifications
Work independently to define problems, identify causes, and initiate steps necessary for resolution in a timely manner
Regularly meet, and effectively communicate with, Supervisor Claims Management, onshore and/or offshore team members to ensure highest level of reimbursement is achieved
Holistically approach client performance by utilizing big picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow though
Monitor and measure client performance outcomes in comparison to client commitments; identify barriers, seek and suggest solutions when desired outcomes are not achieved
Stay abreast of industry changes and regulations to ensure adherence and proactive preparedness
Exhibit strong customer service skills to build and maintain internal and external relationships in order to best address client needs.

Requirements

What you’ll need

High School Diploma
At least 1-2 years of experience processing health insurance claims and/or denials or other healthcare accounts receivable experience, or 1-2 years medical billing experience or at least 1 year EMS billing experience
Ability to holistically approach client performance by utilizing big picture analysis, critical and lean thinking, innovation, curiosity, tenacity, and consistent and timely follow though
Ability to organize, prioritize and multi-task
Ability to learn, understand, and work within specific compliance, client, and payer requirements
Approach all tasks, duties, and interactions with an attitude of continuous improvement
Demonstrated understanding of applicable HIPAA regulations, Medicare, Medicaid, insurance, liability, and tertiary payment methods
Willing and able to adapt to changes in work environment, procedures, priorities, and job duties
Ability to function well within a cross-functional team setting and independently
Strong critical thinking and analytical skills and attention to detail
Proficient in Microsoft Office programs
Proficiency in English is necessary for job-related communication, including understanding policies, writing correspondence, and engaging with colleagues or clients.

Benefits

Comp & perks

Individuals in this role are eligible to participate in a discretionary bonus plan
Comprehensive benefit package
Health coverage
Paid time off
Retirement plan