Bilingual Revenue Cycle Specialist II

About the Role:

Job Summary

Rev Cycle Specialist II handles complex account follow-up, denials, and claims resolution, working more independently and applying advanced knowledge of payer rules and billing systems.

Minimum Job Qualifications

Licensure or other certifications: GA HMFA Certified Patient Account Representative (CPAR) Certification (or must obtain with 6 months of hire)

Educational Requirements: High School Diploma or GED

Minimum Experience: Minimum 3 years hospital or professional billing/collections experience.

Other: Strong understanding of payer policies, explanation of benefits interpretation, and patient accounting systems.

Preferred Job Qualifications

Preferred Licensure or other certifications:

Preferred Educational Requirements:

Preferred Experience:

Other:

Job Specific And Unique Knowledge, Skills And Abilities

• Solid knowledge of Revenue Cycle functions, including registration, authorization, and insurance billing.
• Personal computer proficiency to include all programs necessary to perform job duties and ability to toggle between systems efficiently.
• Excellent listening and problem-solving skills with attention to details.
• Excellent customer service skills and ability to remain calm and professional in stressful situations.
• Excellent verbal and written communication skills.
• Ability to work independently within guidelines.

Essential Tasks And Responsibilities

• Review, resubmit, and follow up on complex insurance claims.
• Perform detailed account research and update account information accurately.
• Resolve denials and ensure adherence to payer contract requirements.
• Maintain work queues and ensure timely resolution of accounts.
• Provide support to teammates and cross-train in additional revenue cycle functions.
• Demonstrate strong documentation, analytics, professionalism, and customer service.

Physical Demands

• Weight Lifted: Up to 20 lbs, Occasionally 0-30% of time
• Weight Carried: Up to 20 lbs, Occasionally 0-30% of time
• Vision: Moderate, Occasionally 0-30% of time
• Kneeling/Stooping/Bending: Occasionally 0-30%
• Standing/Walking: Occasionally 0-30%
• Pushing/Pulling: Occasionally 0-30%
• Intensity of Work: Frequently 31-65%
• Job Requires: Reading, Writing, Reasoning, Talking, Keyboarding

Key skills/competency

• Revenue Cycle Specialist
• Medical Billing
• Collections
• Denial Resolution
• Payer Policies
• Patient Accounting Systems
• Insurance Claims
• Account Follow-up
• Customer Service
• Bilingual