Revenue Cycle Operations Specialist at AllCare Georgia

Atlanta, Georgia, United States -

Full Time

Start Date

Immediate

Expiry Date

29 Dec, 25

Salary

0.0

Posted On

30 Sep, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Revenue Cycle Management, Credentialing, Enrollment, Coding, Documentation, Claims Processing, Patient Communication, Reporting, Accounts Receivable, Analytical Skills, Organizational Skills, Communication Skills, Billing, Compliance, ICD-10 Certification, Athena Experience

Industry

Hospitals and Health Care

Description

Description Are you a detail-oriented professional with a passion for healthcare operations and revenue cycle management? Join our team as a Revenue Cycle Operations Specialist and play a key role in streamlining processes, improving claim accuracy, and supporting patient and provider communications. Credentialing & Enrollment · Manage Medicare and Piedmont provider credentialing and location updates. · Research and facilitate enrollment for miscellaneous insurances. · Maintain CAQH profiles and update provider credentials in Athena. Coding & Documentation · Collaborate with Omega weekly to resolve coding queries. · Audit coding accuracy and research payer requirements. · Review provider documentation and modifier holds for timely filing. Claims & Holds · Process an average of 50 holds daily, including coding and credentialing. · Review Explanation of Benefits (EOBs) and adjust patient balances. · Create claims for self-pay and late cancellation/no-show fees. Patient Communication · Respond to patient emails and biller inbox inquiries. · Escalate billing complaints and provide weekly collection call lists. Reporting & A/R · Prepare weekly revenue cycle and goal update reports. · Review outstanding A/R and follow up with insurance and patients. · Conduct payment research and process refunds. Special Projects · Maintain fee schedules, allowed amounts, and Athena cases. · Monitor payment mismatches and communicate with Mindoula on denied claims. Meetings & Collaboration · Participate in weekly and monthly meetings with internal and external teams. · Support cancellation tracker reviews and insurance accuracy audits. Requirements What You Bring Bachelor’s degree in Finance, Healthcare Administration, or equivalent experience. 5–7 years of experience in healthcare revenue cycle management. Athena experience required; CAQH familiarity preferred. ICD-10 Certification. Strong knowledge of billing, coding, and compliance. Excellent analytical, organizational, and communication skills. Sign on bonus at the end of 90 days dependent on knowledge

Responsibilities

The Revenue Cycle Operations Specialist will manage provider credentialing, facilitate insurance enrollment, and process claims. This role also involves auditing coding accuracy and improving patient communications.